MRS. SAMANTHA A. RUDER (FNP-BC) – Nurse Practitioner, NPI 1356099691
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
Provider Addresses for MRS. SAMANTHA A. RUDER (FNP-BC)
7360 SORREL CT
COLUMBUS, GA 319096039
Phone: (303) 408-7050
Type: Location
222 N PACIFIC COAST HWY STE 2175
EL SEGUNDO, CA 902455639
Phone: (877) 878-3289
Type: Mailing
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: 2025-05-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241016004550 | I | Nurse Practitioner | TX | TBD |
| I20250523002264 | I | Nurse Practitioner | KS | TBD |
| I20250523002422 | I | Nurse Practitioner | MO | TBD |
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.
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 31909)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Vascular Surgery, General Surgery | MO | |
| C H I R O P R A C T I C | MO | |
| Physical Therapist In Private Practice | MO | |
| Nurse Practitioner | MO | |
| C H I R O P R A C T I C | MO | |
| Vascular Surgery | MO | |
| Physical Therapist In Private Practice | MO | |
| C H I R O P R A C T I C | KS | |
| - | SC | |
| Nurse Practitioner | MO |
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