Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SAMANTHA ANNE BERTHOLD MD
NPI 1114850286
Family Medicine in Wichita, KS

Q: What is Samantha Berthold's NPI number?

The NPI number for Samantha Berthold is 1114850286. It was assigned to this individual provider in the NPPES registry on June 8, 2026. The provider is also known as Samantha Anne Clark.

Q: What is Samantha Berthold's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Berthold was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 08, 2026PECOS Enrolled

707 N. EMPORIA AVE, WICHITA, KS 67214(316) 858-3460(316) 858-3499 Get Directions Write a Review

NPPES record added: July 8, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Samantha Anne Berthold Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA ANNE BERTHOLD MD (NPI 1114850286) is an individual family medicine provider in Wichita, Kansas, licensed in Kansas (94-12835) and active in the NPI registry since June 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114850286

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSAMANTHA ANNE BERTHOLDCredential: MD

Location Address707 N. EMPORIA AVEWichita, KS 67214

Mailing Address1010 N Kansas StWichita, KS 67214-3124 · (316) 293-2665

Phone(316) 858-3460

Fax(316) 858-3499

Sole ProprietorNo

Enumeration DateJune 8, 2026

Last NPPES UpdateJuly 8, 2026

NPPES CertifiedJuly 8, 2026

✔ NPI 1114850286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in KS · 94-12835

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

707 N. EMPORIA AVE, Wichita, KS 67214

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Other Names 1

Former Name (1)Samantha Anne Clark

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Anne Berthold Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 67214 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.98 typical visit price

range $53.00 – $161.67

Typical copayment $20.49 (range $13.25 – $40.41)

Most-billed visit code 99203

Established Patient

$94.12 typical visit price

range $16.88 – $132.11

Typical copayment $23.53 (range $4.22 – $33.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Berthold's NPI number?

The NPI number for Samantha Berthold is 1114850286. It was assigned to this individual provider in the NPPES registry on June 8, 2026. The provider is also known as Samantha Anne Clark.

Where is Samantha Berthold located?

Samantha Berthold practices at 707 N. Emporia Ave, Wichita, KS 67214. The listed phone number is (316) 858-3460.

What is Samantha Berthold's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Samantha Berthold enrolled in Medicare?

Yes. Samantha Berthold is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samantha Berthold was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.