SAMANTHA DAVIS (APRN) – Family Nurse Practitioner, NPI 1124537162

SAMANTHA DAVIS (APRN) is a healthcare provider. based in Mena, Arkansas. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 10059663 (OR). The NPI Number for SAMANTHA DAVIS (APRN) is 1124537162

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA DAVIS (APRN)
NPI
1124537162
Phone
(888) 710-8220
Address
PO BOX 1848
Enumeration Date
21 September 2017
Last Update Date
1 June 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5016237900
Graduation Year
2017 (9 years ago)
PAC ID
2860758554
Group Practice PAC ID
5698665685
Professional Enrollment ID
I20171114000052
Address ID
AR719019476HO4517XAVEX300
Data current as of
10 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:8State licenses:2Digital endpointsOther names

3,410 NURSE PRACTITIONER in AR

Provider Addresses for SAMANTHA DAVIS (APRN)

  • PO BOX 1848

    MENA, AR 719531841

    Phone: (888) 710-8220

    Fax: (866) 573-0761

    Type: Mailing

  • 2323 N HIGHWAY 229 STE B

    HASKELL, AR 720157244

    Phone: (888) 710-8220

    Fax: (866) 573-0761

    Type: Location

  • 139 COOLEY LN

    DE QUEEN, AR 718328834

    Phone: (870) 828-1824

    Type: Mailing

  • PO BOX 740

    DE QUEEN, AR 718320740

    Phone: (870) 828-1824

    Type: Mailing

  • 1553, West Collin Raye Drive, De Queen, Sevier County, Arkansas, 71832, United States

    DE QUEEN, AR 718323801

    Phone: (870) 584-3000

    Type: Location

  • 415 CROOKED RD

    DE QUEEN, AR 718329024

    Phone:

    Type: Mailing

  • 2710 Willamette St

    Eugene, OR 974053238

    Phone: (541) 640-7625

    Fax: (541) 644-3477

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171114000052INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 71953)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698665685View full group profile
NameSpecialtyState
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
Family PracticeAR
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
Family PracticeAR
Internal MedicineAR
Family PracticeAR

Reviews

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Frequently asked questions

Is SAMANTHA DAVIS (APRN) listed with a National Provider Identifier?
Yes — SAMANTHA DAVIS (APRN) has NPI 1124537162 on file in the registry.
Active or inactive — what applies to SAMANTHA DAVIS (APRN)?
You should see SAMANTHA DAVIS (APRN) as active in CMS-hosted NPPES data.
What clinical focus is listed for SAMANTHA DAVIS (APRN)?
At a glance, SAMANTHA DAVIS (APRN) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SAMANTHA DAVIS (APRN) associated with Mena?
Public fields place SAMANTHA DAVIS (APRN) around Mena, Arkansas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.