| Samantha Danielle Statham, NP | |
|
129 Center St Ste B, Richland, MS 39218-4800 | |
| (769) 233-7141 | |
| Not Available |
| Full Name | Samantha Danielle Statham |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 129 Center St Ste B, Richland, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568291672 | NPI | - | NPPES |
| 37098 | Other | TN | STATE LICENSE |
| 906894 | Other | MS | LICENSURE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 37098 (Tennessee) | Primary |
| 363L00000X | Nurse Practitioner | 906894 (Mississippi) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medical Systems Management, Llc | 5092964643 | 49 |
| Entity Name | Medical Systems Management, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740555267 PECOS PAC ID: 5092964643 Enrollment ID: O20131024001113 |
| Mailing Address | Practice Location Address |
|---|---|
| Samantha Danielle Statham, NP 129 Center St Ste B, Richland, MS 39218-4800 Ph: (769) 233-7141 | Samantha Danielle Statham, NP 129 Center St Ste B, Richland, MS 39218-4800 Ph: (769) 233-7141 |
Laquana Daniels, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 119 Rhemann Blvd, Richland, MS 39218 Phone: 601-248-5198 |
Ashley Bruce, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1132 Highway 49 S, Richland, MS 39218 Phone: 601-664-1620 |
Denisa Broome Wilson, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 907 Us 49, Richland, MS 39218 Phone: 601-374-5263 |
Mr. James A Marx, C.F.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1201 Highway 49 S, Suite 4, Richland, MS 39218 Phone: 601-932-6400 Fax: 601-932-6437 |
Ashley Smith Allen, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Rankin Rural Medical Center, 129 Center Street Suite B, Richland, MS 39218 Phone: 769-233-7141 |
Darby Raybourn Wade, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 128 Riverview Dr, Richland, MS 39218 Phone: 601-326-1960 Fax: 601-326-1706 |
Linda Nell Hunter, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1201 Highway 49 S Ste 4, Richland, MS 39218 Phone: 601-932-6400 Fax: 601-664-0006 |