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KATHRYN B SAMPLES P.A.-C.
NPI 1386628790
Physician Assistant - Surgical in Carrollton, GA

Active since November 30, 2005PECOS EnrolledAccepts Medicare Assignment
157 CLINIC AVE, SUITE 302, CARROLLTON, GA 30117(770) 834-3336(770) 832-2136 Get Directions Write a Review

NPPES record last updated: January 27, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kathryn B Samples P.a.-c. NPPES

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

KATHRYN B SAMPLES P.A.-C. (NPI 1386628790) is an individual surgical provider in Carrollton, Georgia, licensed in Georgia (003055) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Tanner Medical Center - Carrollton, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1386628790
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameKATHRYN B SAMPLESCredential: P.A.-C.
Location Address157 CLINIC AVE, SUITE 302Carrollton, GA 30117-4413
Mailing Address119 Ambulance Dr, Suite 202Carrollton, GA 30117-3857 · (770) 838-8710
Phone(770) 834-3336
Fax(770) 832-2136
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateNovember 30, 2005
Last NPPES UpdateJanuary 27, 2016
✔ NPI 1386628790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in GA · 003055
157 CLINIC AVE, Carrollton, GA 30117
Open in Google Maps ↗

Other Identifiers 1

Medicaid100000202AGA

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

Kathryn B Samples P.a.-c. 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 ID5193735587
PECOS Enrollment IDI20060501000030
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
12 services11 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Tanner Medical Center - Carrollton

Acute Care Hospitals · Carrollton, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110011
Location705 Dixie StreetCarrollton, GA 30117 · Carroll County
Birthing friendly

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.

DAVID W GRIFFIN M.D.
Surgery
157 CLINIC AVE, SUITE 302
CARROLLTON, GA 30117
Carroll County (770) 834-3336
NORTHWEST GEORGIA ONCOLOGY CENTERS, PC
Durable Medical Equipment & Medical Supplies
157 CLINIC AVE, STE 101
CARROLLTON, GA 30117
Carroll County (770) 333-2220
PHYSICIANS CHOICE DIALYSIS OF WEST GEORGIA, LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
157 CLINIC AVE, SUITE 102
CARROLLTON, GA 30117
Carroll County (770) 832-2202
DAVID ERIC SCHOENFELD M.D.
Dermatology
157 CLINIC AVE, SUITE 301
CARROLLTON, GA 30117
Carroll County (770) 838-9333
DR. SCOTT ALVIN DENHAM M.D.
Emergency Medicine
157 CLINIC AVE, SUITE 302
CARROLLTON, GA 30117
Carroll County (770) 838-3336
DR. BRADLEY J. G. LARSON MD
Internal Medicine (Hematology & Oncology)
157 CLINIC AVE, STE 101
CARROLLTON, GA 30117
Carroll County (770) 333-2220
MARIA JOCELYN ORIG MD
Internal Medicine (Nephrology)
157 CLINIC AVE, STE 203
CARROLLTON, GA 30117
Carroll County (770) 832-0429
CARROLL COUNTY NEPHROLOGY LLC
Internal Medicine (Nephrology)
157 CLINIC AVE, SUITE 203
CARROLLTON, GA 30117
Carroll County (770) 832-0429

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 Kathryn Samples's NPI number?

The NPI number for Kathryn Samples is 1386628790. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Kathryn Samples located?

Kathryn Samples practices at 157 Clinic Ave Suite 302, Carrollton, GA 30117. The listed phone number is (770) 834-3336.

What is Kathryn Samples's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kathryn Samples enrolled in Medicare?

Yes. Kathryn Samples 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.

Is Kathryn Samples affiliated with any hospitals?

According to CMS data, Kathryn Samples is affiliated with Tanner Medical Center - Carrollton.

When was this NPI record last updated?

The NPPES record for Kathryn Samples was last updated on January 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.