SAMANTHA RENEE FRALEY – Family Nurse Practitioner, NPI 1154133676

SAMANTHA RENEE FRALEY is a healthcare provider. based in Big rock, Virginia. specializing in NURSE PRACTITIONER. They hold a License No. 0024192519 (VA). The NPI Number for SAMANTHA RENEE FRALEY is 1154133676

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA RENEE FRALEY
NPI
1154133676
Phone
(423) 754-7768
Address
PO BOX 144
Enumeration Date
22 January 2025
Last Update Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2769352880
Graduation Year
2024 (2 years ago)
PAC ID
1052833704
Group Practice PAC ID
9931206232
Professional Enrollment ID
I20250321002846
Address ID
VA246560000VA18765DRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for SAMANTHA RENEE FRALEY

  • PO BOX 144

    BIG ROCK, VA 246030144

    Phone: (423) 754-7768

    Type: Mailing

  • 21956 RIVERSIDE DR STE 7

    GRUNDY, VA 246149400

    Phone: (276) 285-8764

    Fax: (276) 312-8008

    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: 2025-03-21

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250321002846INurse PractitionerVATBD

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 24603)

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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: 9931206232View full group profile
NameSpecialtyState
Nurse PractitionerVA
Nurse PractitionerVA
Nurse PractitionerWV

Reviews

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Frequently asked questions

Is SAMANTHA RENEE FRALEY listed with a National Provider Identifier?
Yes — SAMANTHA RENEE FRALEY has NPI 1154133676 on file in the registry.
Active or inactive — what applies to SAMANTHA RENEE FRALEY?
You should see SAMANTHA RENEE FRALEY as active in CMS-hosted NPPES data.
What area of care is associated with SAMANTHA RENEE FRALEY?
SAMANTHA RENEE FRALEY's record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Virginia is SAMANTHA RENEE FRALEY registered?
Use Big Rock, Virginia as the headline location for SAMANTHA RENEE FRALEY here.
Does SAMANTHA RENEE FRALEY accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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