Mrs Samantha D'ann Blackburn, AGACNP - BC; FNP-C - Medicare Nurse Practitioner in Fruitland, ID

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Mrs Samantha D'ann Blackburn, AGACNP - BC; FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Fruitland, Idaho. Her current practice location is 808 N Whitley Dr, Fruitland, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 452-2672.

Mrs Samantha D'ann Blackburn is licensed to practice in Idaho (license number 65041) 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 1811534613.

Contact Information

Mrs Samantha D'ann Blackburn, AGACNP - BC; FNP-C
808 N Whitley Dr,
Fruitland, ID 83619-2437
(208) 452-2672
Not Available

Map and Direction




Provider's Profile

Full NameMrs Samantha D'ann Blackburn
GenderFemale
SpecialityNurse Practitioner - Family
Location808 N Whitley Dr, Fruitland, Idaho
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1811534613
  • Provider Enumeration Date: 11/29/2019
  • Last Update Date: 01/07/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 9234536855
  • Enrollment ID: I20210924001101

Medical Identifiers

Medical identifiers for Mrs Samantha D'ann Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811534613NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 47259 (Idaho)Secondary
363LA2100XNurse Practitioner - Acute Care 65041 (Idaho)Secondary
363LF0000XNurse Practitioner - Family 65041 (Idaho)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Samantha D'ann Blackburn allows following entities to bill medicare on her behalf.
Entity NameMeridian Advanced Psychiatry , Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609412683
PECOS PAC ID: 8628490711
Enrollment ID: O20200618000604
Entity NameAncora Hospice & Palliative Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558933440
PECOS PAC ID: 6204230980
Enrollment ID: O20220201000124

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. Mrs Samantha D'ann Blackburn 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
Mrs Samantha D'ann Blackburn, AGACNP - BC; FNP-C
808 N Whitley Dr,
Fruitland, ID 83619-2437

Ph: (208) 452-2672		Mrs Samantha D'ann Blackburn, AGACNP - BC; FNP-C
808 N Whitley Dr,
Fruitland, ID 83619-2437

Ph: (208) 452-2672

Reviews and Comments


Nurse Practitioner Nurses in Fruitland, ID

Katlin Nicole Foote, FNP
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Practice Location: 910 Nw 16th St, Ste 101, Fruitland, ID 83619
Phone: 208-452-8000    Fax: 208-452-8055
Mrs. Jeanna Rae Rendo, NP-C
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Practice Location: 811 Nw 12th St, Fruitland, ID 83619
Phone: 208-452-7450    
Brianne Minor, NP
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Practice Location: 811 Nw 12th St, Fruitland, ID 83619
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Kourtney Holder, DNP, FNP-C
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Phone: 208-452-8000    Fax: 208-452-8055
Mrs. Jeanette Hazel Marie Reiners, DNP, FNP
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Practice Location: 910 Nw 16th St, Fruitland, ID 83619
Phone: 208-452-8000    
Ms. Melissa Anne Pace, NP
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Practice Location: 811 Nw 12th St, Fruitland, ID 83619
Phone: 208-452-7450    Fax: 208-452-7550

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.