SAMANTHA RENEE FRALEY
NPI 1154133676
Nurse Practitioner - Family in Grundy, VA

Active since January 22, 2025PECOS EnrolledAccepts Medicare Assignment
21956 RIVERSIDE DR STE 7, GRUNDY, VA 24614(276) 285-8764(276) 312-8008 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 22, 2026, Dec 31, 2025, Nov 30, 2025 and 1 more (4 updates tracked since 2025).

About Samantha Renee Fraley NPPES

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

SAMANTHA RENEE FRALEY (NPI 1154133676) is an individual family provider in Grundy, Virginia, licensed in Virginia (0024192519) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1154133676
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSAMANTHA RENEE FRALEY
Location Address21956 RIVERSIDE DR STE 7Grundy, VA 24614-9400
Mailing AddressPo Box 144Big Rock, VA 24603-0144 · (423) 754-7768
Fax(276) 312-8008
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 22, 2025
Last NPPES UpdateJanuary 22, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2026
✔ NPI 1154133676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in VA · 0024192519
21956 RIVERSIDE DR STE 7, Grundy, VA 24614

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Renee Fraley is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052833704
PECOS Enrollment IDI20250321002846
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Samantha Fraley reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Same address
Clinic/Center
21956 RIVERSIDE DR STE 7
Grundy, VA 24614
  • Reassigned Medicare billing, Virginia enrollment
  • 2 clinicians in this Medicare group
Family Medicine
18765 RIVERSIDE DRIVE
Vansant, VA 24656
  • Reassigned Medicare billing, Virginia enrollment
  • 13 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24614 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center
21956 RIVERSIDE DR STE 7
GRUNDY, VA 24614
Nurse Practitioner (Family)
21956 RIVERSIDE DR STE 7
GRUNDY, VA 24614

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 Fraley's NPI number?

The NPI number for Samantha Fraley is 1154133676. It was assigned to this individual provider in the NPPES registry on January 22, 2025.

Where is Samantha Fraley located?

Samantha Fraley practices at 21956 Riverside Dr Ste 7, Grundy, VA 24614. The listed phone number is (276) 285-8764.

What is Samantha Fraley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Samantha Fraley enrolled in Medicare?

Yes. Samantha Fraley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samantha Fraley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Fraley reassigns Medicare benefits to 2 organizations: Tox Sisters LLC (Grundy, VA) and Appalachian Family Care, LLC (Vansant, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Fraley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samantha Fraley was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.