SAMANTHA NICOLE GLENN ETHEREDGE
NPI 1386221844
Family Medicine - Sports Medicine in Pascagoula, MS

Q: What is Samantha Glenn Etheredge's NPI number?

The NPI number for Samantha Glenn Etheredge is 1386221844. It was assigned to this individual provider in the NPPES registry on March 29, 2021.

Q: What is Samantha Glenn Etheredge's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since March 29, 2021PECOS EnrolledAccepts Medicare Assignment

3101 DENNY AVE STE 240, PASCAGOULA, MS 39581(228) 872-1951(228) 875-9998 Get Directions Write a Review

NPPES record last updated: September 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 30, 2024, Jun 24, 2024, Sep 29, 2022 and 1 more (4 updates tracked since 2021).

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About Samantha Nicole Glenn Etheredge NPPES

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

SAMANTHA NICOLE GLENN ETHEREDGE (NPI 1386221844) is an individual sports medicine provider in Pascagoula, Mississippi, licensed in Mississippi (35673) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with Singing River Health System, and is a graduate of Alabama College Of Osteopathic Medicine (2021).

NPPES Registry Identity

NPI1386221844

Entity TypeIndividualFemale

Primary Taxonomy207QS0010X

Provider Legal NameSAMANTHA NICOLE GLENN ETHEREDGE

Location Address3101 DENNY AVE STE 240Pascagoula, MS 39581-5307

Mailing Address2101 Highway 90Gautier, MS 39553-5340 · (228) 497-7576 · Fax (228) 497-8869

Phone(228) 872-1951

Fax(228) 875-9998

Sole ProprietorNo

Medical School CMSAlabama College Of Osteopathic MedicineGraduated 2021

Enumeration DateMarch 29, 2021

Last NPPES UpdateSeptember 24, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 24, 2025

✔ NPI 1386221844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

Licenses✔ Licensed in MS · 35673✔ Licensed in AL · 3818

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

3101 DENNY AVE STE 240, Pascagoula, MS 39581

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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

Samantha Nicole Glenn Etheredge 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 ID4385011238

PECOS Enrollment IDI20251007003173

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 2

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

Singing River Health System

Acute Care Hospitals · Pascagoula, MS

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number250040

Location2809 Denny AvenuePascagoula, MS 39581 · Jackson County

Emergency services Birthing friendly

Singing River Gulfport

Acute Care Hospitals · Gulfport, MS

1/5 CMS rating

OwnershipProprietary

CMS Certification Number250123

Location15200 Community RoadGulfport, MS 39503 · Harrison County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39581 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

DR. MATTHEW BERNARD CARROLL M.D.

Internal Medicine (Rheumatology)

3101 DENNY AVE STE 240
PASCAGOULA, MS 39581

Jackson County (228) 696-9995

DR. MARY ELIZABETH LINDSEY D.O.

Internal Medicine (Rheumatology)

3101 DENNY AVE STE 240
PASCAGOULA, MS 39581

Jackson County (228) 696-9995

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 Glenn Etheredge's NPI number?

The NPI number for Samantha Glenn Etheredge is 1386221844. It was assigned to this individual provider in the NPPES registry on March 29, 2021.

Where is Samantha Glenn Etheredge located?

Samantha Glenn Etheredge practices at 3101 Denny Ave Ste 240, Pascagoula, MS 39581. The listed phone number is (228) 872-1951.

What is Samantha Glenn Etheredge's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Samantha Glenn Etheredge enrolled in Medicare?

Yes. Samantha Glenn Etheredge 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.

What insurance does Samantha Glenn Etheredge accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Samantha Glenn Etheredge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samantha Glenn Etheredge affiliated with any hospitals?

According to CMS data, Samantha Glenn Etheredge is affiliated with Singing River Health System and Singing River Gulfport.

When was this NPI record last updated?

The NPPES record for Samantha Glenn Etheredge was last updated on September 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.