SAMUEL COPELAND GILMORE PA
NPI 1164149019
Physician Assistant in Beckley, WV

Q: What is Samuel Gilmore's NPI number?

The NPI number for Samuel Gilmore is 1164149019. It was assigned to this individual provider in the NPPES registry on October 21, 2022.

Q: What is Samuel Gilmore's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Gilmore was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since October 21, 2022PECOS EnrolledAccepts Medicare Assignment

306 STANAFORD RD, BECKLEY, WV 25801(304) 255-3000 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Samuel Copeland Gilmore Pa NPPES

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

SAMUEL COPELAND GILMORE PA (NPI 1164149019) is an individual physician assistant in Beckley, West Virginia, licensed in Virginia (1228984) and active in the NPI registry since October 2022. He is enrolled in Medicare PECOS, is affiliated with Beckley Arh Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1164149019

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSAMUEL COPELAND GILMORECredential: PA

Location Address306 STANAFORD RDBeckley, WV 25801-3142

Mailing Address1055 Quince DrRockingham, VA 22801-5318 · (304) 488-5588

Phone(304) 255-3000

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 21, 2022

Last NPPES UpdateJanuary 27, 2025

NPPES CertifiedJanuary 27, 2025

✔ NPI 1164149019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in VA · 1228984

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

306 STANAFORD RD, Beckley, WV 25801

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Copeland Gilmore Pa 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 ID7911418520

PECOS Enrollment IDI20260416002086

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beckley Arh Hospital

Acute Care Hospitals · Beckley, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510062

Location306 Stanaford RoadBeckley, WV 25801 · Raleigh County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25801 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

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

Most-billed visit code 99213

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 20

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

ANITA COLEMAN LAW CRNA

Nurse Anesthetist, Certified Registered