Samantha Nicole Glenn Etheredge, - Medicare Family Medicine in Pascagoula, MS

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Samantha Nicole Glenn Etheredge, is a medicare enrolled "Family Medicine - Sports Medicine" physician in Pascagoula, Mississippi. Her current practice location is 3101 Denny Ave Ste 240, Pascagoula, Mississippi. You can reach out to her office (for appointments etc.) via phone at (228) 872-1951.

Samantha Nicole Glenn Etheredge is licensed to practice in Mississippi (license number 35673) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1386221844.

Contact Information

Samantha Nicole Glenn Etheredge,
3101 Denny Ave Ste 240,
Pascagoula, MS 39581-5307
(228) 872-1951
(228) 875-9998

Map and Direction




Physician's Profile

Full NameSamantha Nicole Glenn Etheredge
GenderFemale
SpecialityFamily Medicine - Sports Medicine
Location3101 Denny Ave Ste 240, Pascagoula, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1386221844
  • Provider Enumeration Date: 03/29/2021
  • Last Update Date: 09/24/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 4385011238
  • Enrollment ID: I20221104002214

Medical Identifiers

Medical identifiers for Samantha Nicole Glenn Etheredge such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1386221844NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QS0010XFamily Medicine - Sports Medicine 35673 (Mississippi)Primary
207QS0010XFamily Medicine - Sports Medicine 3818 (Alabama)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Nicole Glenn Etheredge is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samantha Nicole Glenn Etheredge,
2101 Highway 90,
Gautier, MS 39553-5340

Ph: (228) 497-7576		Samantha Nicole Glenn Etheredge,
3101 Denny Ave Ste 240,
Pascagoula, MS 39581-5307

Ph: (228) 872-1951

Reviews and Comments


Family Medicine Doctors in Pascagoula, MS

Dr. Kevin Scott Cooper, MD,MPH
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 4305 Denny Ave, Pascagoula, MS 39581
Phone: 228-762-2044    Fax: 228-762-2064
Dr. Gary H. Groff, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2819 Denny Ave., Pascagoula, MS 39581
Phone: 228-762-3466    Fax: 228-762-6349
Dr. Martin Bydalek, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 2819 Denny Ave, Pascagoula, MS 39581
Phone: 228-762-3466    
Dr. Teresa A Williamson, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2819 Denny Ave., Pascagoula, MS 39581
Phone: 228-762-3466    Fax: 228-762-6349
Dr. Vernon W Doster, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 3616 Hospital Street, Suite D, Pascagoula, MS 39581
Phone: 228-762-8187    Fax: 228-762-6934
Dr. Christopher Erik Bowen, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2809 Denny Ave, Pascagoula, MS 39581
Phone: 228-809-5510    Fax: 228-809-5519

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.