NPIMap

Individual provider Active NPI

Samandra Tann, NP-C

  • Nurse Practitioner
  • Durham, NC
National Provider Identifier
1093830291
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
171266 Issued in NC
Practice address
2645 Meridian Pkwy Ste 323
Durham, NC 27713-4232
Phone
(984) 227-8902
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 171266 NC Primary

Addresses

Primary practice location

2645 Meridian Pkwy Ste 323
Durham, NC 27713-4232

Mailing address

301 E Wendover Ave
Suite 200
Greensboro, NC 27401-1207
Phone (336) 274-3241

Other practice location 1

324 W Wendover Ave
Suite 200
Greensboro, NC 27408-8437
Phone (336) 274-6515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070614000665 NC Practitioner - Nurse Practitioner 0547368524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

306 Westwood Ave
Suite 401
High Point, NC 27262-4342
Phone (336) 885-6168

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • High Point Regional Health System Hospital, High Point, NC, CCN 340004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Dec 12, 2024 Accepting new patients
Eagle Physicians and Associates PA Current Accepting new patients
Eagle Physicians and Associates PA CurrentSince Feb 1, 2014 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Feb 1, 2014 Accepting new patients
Arete Medical Services, L.L.C. Nurse Practitioner Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

301 E Wendover Ave
Ste 200
Greensboro, NC 27401
Phone (336) 274-3241

324 W Wendover Ave
Ste 200
Greensboro, NC 27408
Phone (336) 274-6515

306 Westwood Ave
Ste 401
High Point, NC 27262
Phone (336) 885-6168

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: stann2962186@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: stann@landmarkhealth-direct.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1093830291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E WENDOVER AVE",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011207",
            "telephone_number": "336-274-3241",
            "fax_number": "336-272-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 MERIDIAN PKWY STE 323",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134232",
            "telephone_number": "984-227-8902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 W Wendover Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274088437",
            "country_code": "US",
            "telephone_number": "336-274-6515",
            "fax_number": "336-275-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANN",
        "first_name": "SAMANDRA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "171266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.