SAMANTHA KAY NOETH (MMSN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1245706548
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for SAMANTHA KAY NOETH (MMSN)
787 SUNSET BLVD STE 200
O FALLON, IL 622691960
Phone: (618) 726-2229
Fax: (618) 726-2225
Type: Mailing
715 Broadway St
Gillespie, IL 620331166
Phone: (217) 839-4491
Fax: (217) 839-2689
Type: Location
715, Broadway Street, Gillespie, Macoupin County, Illinois, 62033, United States
GILLESPIE, IL 620331166
Phone: (217) 839-4491
Fax: (217) 839-2689
Type: Location
12 N 64TH ST
BELLEVILLE, IL 622233809
Phone: (618) 877-4420
Type: Location
715 BROADWAY ST
GILLESPIE, IL 620331166
Phone: (217) 839-4491
Fax: (217) 839-5030
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $1,122.
Total Amount is formed as General ($1,122) + Research ($0) + Ownership ($0) = $1,122.
Last reported payment date: 2024-11-11 • Largest payer in this snapshot: ABBVIE INC. ($227).
Total Amount
$1,122
General + Research + Ownership
Payments
28
Total payment records
General Amount
$1,122
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-11
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2018-11-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181121000244 | I | Nurse Practitioner | IL | 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 62269)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | IL | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | IL | |
| Psychiatry, Geriatric Psychiatry | IL | |
| Mental Health Counselor | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
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