SAMANTHA CLARK
NPI 1710593462
Nurse Practitioner in Germantown, TN

Q: What is Samantha Clark's NPI number?

The NPI number for Samantha Clark is 1710593462. It was assigned to this individual provider in the NPPES registry on September 18, 2020.

Q: What is Samantha Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Clark was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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 September 18, 2020PECOS EnrolledAccepts Medicare Assignment

1355 W BRIERBROOK RD, GERMANTOWN, TN 38138(901) 390-2930 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 30, 2024, May 6, 2021, Sep 18, 2020 (3 updates tracked since 2020).

On this page

About Samantha Clark NPPES

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

SAMANTHA CLARK (NPI 1710593462) is an individual nurse practitioner in Germantown, Tennessee, licensed in Tennessee (32815) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS, maintains 10 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1710593462

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSAMANTHA CLARK

Location Address1355 W BRIERBROOK RDGermantown, TN 38138-2208

Mailing Address1375 W Brierbrook RdGermantown, TN 38138-2208 · (901) 390-2930

Phone(901) 390-2930

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateSeptember 18, 2020

Last NPPES UpdateJanuary 22, 20253 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2025

✔ NPI 1710593462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in TN · 32815✔ Licensed in MS · 904503

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1355 W BRIERBROOK RD, Germantown, TN 38138

Open in Google Maps ↗

Secondary Practice Locations 10

Location 11385 W Brierbrook RdGermantown, TN 38138-2208 · Phone (901) 390-2930

Location 2705 N State StClarksdale, MS 38614-6519 · Phone (901) 390-2930

Location 3176 Goodman Rd WSouthaven, MS 38671-9405 · Phone (901) 390-2930

Location 4405 River RdGreenwood, MS 38930-4212 · Phone (901) 390-2930

Location 51750 Madison Ave Ste 302Memphis, TN 38104-6428 · Phone (901) 390-2930

Location 61750 Madison Ave Ste 301Memphis, TN 38104-6428 · Phone (901) 390-2930

Location 78081 US Highway 51 NMillington, TN 38053-1730 · Phone (901) 390-2930

Location 8403 Getwell DrSenatobia, MS 38668-2213 · Phone (901) 390-2930

Location 92704 W Oxford Loop Ste 110Oxford, MS 38655-5728 · Phone (901) 390-2930

Location 101300 Sunset Dr Ste PGrenada, MS 38901-4084 · Phone (901) 390-2930

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 Health and more.Insurance ›

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 Clark 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 ID1658769005

PECOS Enrollment IDI20211104000103, I20230421000649

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 Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vascular And Vein Institute Of The South, PLLC

0.1 mi

Vascular Surgery

1385 W BRIERBROOK RD
Germantown, TN 38138

Reassigned Medicare billing, Mississippi and Tennessee enrollments
11 clinicians in this Medicare group

NPI 1275016941 (561) 312-1082

Oak Hill Health Services, LLC

53 mi

Family Medicine

2580 JACKSON AVE W STE 44
Oxford, MS 38655

Reassigned Medicare billing, Mississippi enrollment
12 clinicians in this Medicare group

NPI 1265934012 (662) 816-7199

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 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

279 services192 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

124 services124 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

112 services100 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

73 services73 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

33 services32 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38138 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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 10

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

MICHAEL RICHARD COREY M.D.

Surgery (Vascular Surgery)