SAMANTHA JEAN THEOBALD FNP
NPI 1508563347
Nurse Practitioner - Family in Charleston, SC

Q: What is Samantha Theobald's NPI number?

The NPI number for Samantha Theobald is 1508563347. It was assigned to this individual provider in the NPPES registry on February 13, 2023.

Q: What is Samantha Theobald's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samantha Theobald was last updated on February 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since February 13, 2023PECOS EnrolledAccepts Medicare Assignment

27 GAMECOCK AVE STE 201, CHARLESTON, SC 29407(843) 769-8215(843) 769-8216 Get Directions Write a Review

NPPES record last updated: February 13, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Samantha Jean Theobald Fnp NPPES

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

SAMANTHA JEAN THEOBALD FNP (NPI 1508563347) is an individual family provider in Charleston, South Carolina, licensed in South Carolina (27061) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS, is affiliated with Mount Pleasant Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1508563347

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA JEAN THEOBALDCredential: FNP

Location Address27 GAMECOCK AVE STE 201Charleston, SC 29407-3398

Mailing Address27 Gamecock Ave Ste 201Charleston, SC 29407-3398 · (843) 769-8215 · Fax (843) 769-8216

Phone(843) 769-8215

Fax(843) 769-8216

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateFebruary 13, 2023

NPPES CertifiedFebruary 13, 2023

✔ NPI 1508563347 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 SC · 27061

27 GAMECOCK AVE STE 201, Charleston, SC 29407

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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 Jean Theobald Fnp 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 ID8325405483

PECOS Enrollment IDI20230605001717

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

Medicare enrollment records show Samantha Theobald reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

John E. Emmel, MD, PC

Same address

Geriatric Medicine

27 GAMECOCK AVE, STE 201
Charleston, SC 29407

Reassigned Medicare billing, South Carolina enrollment
26 clinicians in this Medicare group

NPI 1235263534 (843) 769-8215

Curana Health Of South Carolina PC

1.9 mi

Internal Medicine

2375 BAKER HOSPITAL BLVD
North Charleston, SC 29405

Reassigned Medicare billing, South Carolina enrollment
409 clinicians in this Medicare group

NPI 1316477896 (337) 991-9276

Ch Specialty Services Sc LLC

7.0 mi

Family

6650 RIVERS AVE
North Charleston, SC 29406

Reassigned Medicare billing, South Carolina enrollment
338 clinicians in this Medicare group

NPI 1275915522 (337) 991-9276

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

Areas of Expertise CMS Part B claims 5

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

1,269 services199 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

256 services54 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

213 services95 patients

Nursing facility discharge management, more than 30 minutes 99316

Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.

145 services133 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

92 services31 patients

Hospital Affiliations CMS Care Compare

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

Mount Pleasant Hospital

Acute Care Hospitals · Mount Pleasant, SC

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420104

Location3510 Highway 17 North Suite 140Mount Pleasant, SC 29466 · Charleston County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29407 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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 5

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

MRS. DEBRA PORTER NP

Nurse Practitioner (Family)