SAMANTHA QUILLEN (CNP) – Family Nurse Practitioner, NPI 1083018915

SAMANTHA QUILLEN (CNP) is a healthcare provider. based in Dover, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. 16577 (OH). The NPI Number for SAMANTHA QUILLEN (CNP) is 1083018915

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA QUILLEN (CNP)
NPI
1083018915
Phone
(330) 343-0753
Address
110 DUBLIN DR
Enumeration Date
21 October 2014
Last Update Date
12 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3303642700
Graduation Year
2014 (12 years ago)
PAC ID
0749505279
Group Practice PAC ID
0143366591
Professional Enrollment ID
I20150204001425
Address ID
OH446223207DO400XXDRXX404
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for SAMANTHA QUILLEN (CNP)

  • 110 DUBLIN DR

    DOVER, OH 446227805

    Phone: (330) 343-0753

    Type: Mailing

  • 400 MEDICAL PARK DR

    SUITE 201

    DOVER, OH 446223207

    Phone: (330) 343-7709

    Fax: (330) 364-1538

    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: 2015-02-04

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
I20150204001425INurse PractitionerOHTBD

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 44622)

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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: 0143366591View full group profile
NameSpecialtyState
Internal MedicineOH
Nurse PractitionerOH
D E R M A T O L O G YOH
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
Internal Medicine, Emergency Medicine, Cardiovascular Disease (Cardiology)PA
-OH
Nurse PractitionerOH
-OH

Reviews

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Frequently asked questions

What NPI should I save for SAMANTHA QUILLEN (CNP)?
Save NPI 1083018915 if you need a stable reference for SAMANTHA QUILLEN (CNP).
Is SAMANTHA QUILLEN (CNP) active in the national directory?
SAMANTHA QUILLEN (CNP)'s public NPI profile is in an active state.
What does SAMANTHA QUILLEN (CNP) treat or focus on?
Patients typically see SAMANTHA QUILLEN (CNP) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does SAMANTHA QUILLEN (CNP) practice in Ohio?
You will see Dover, Ohio on file for SAMANTHA QUILLEN (CNP) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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