Samara A Champion, MSN, APRN, NP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Muskegon, Michigan. She graduated from medical school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Hackley Community Care Center Inc and her current practice location is
1550 Clinton St, Muskegon, Michigan. You can reach out to her office (for appointments etc.) via phone at
(231) 737-1335.
Samara A Champion is licensed to practice in Michigan (license number 4704232661NSA2109F) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104407691.
Physician's Profile
| Full Name | Samara A Champion |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 1550 Clinton St, Muskegon, Michigan |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Samara A Champion graduated from medical school in 2021
NPI Data:
- NPI Number: 1104407691
- Provider Enumeration Date: 04/16/2021
- Last Update Date: 01/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 6103221312
- Enrollment ID: I20210826002055
Medical Identifiers
Medical identifiers for Samara A Champion such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104407691 | NPI | - | NPPES |
| 1609451905 | Medicaid | MI | |
| 1629066238 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 4704232661 (Michigan) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 4704232661NSA2109F (Michigan) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Hackley Community Care Center Inc | 8123015492 | 19 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samara A Champion allows following entities to bill medicare on her behalf.
| Entity Name | Hackley Community Care Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629066238
PECOS PAC ID: 8123015492
Enrollment ID: O20040511001126 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samara A Champion is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Samara A Champion, MSN, APRN, NP-C
7834 Taylor Ridge Dr,
Delton, MI 49046-7806
Ph: (616) 890-0087 | Samara A Champion, MSN, APRN, NP-C
1550 Clinton St,
Muskegon, MI 49442-5007
Ph: (231) 737-1335 |
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