Samantha Carole Pernell

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

287819 Issued in NC

Practice address

511 Ruin Creek Rd
Henderson, NC 27536-5919

Phone

(252) 436-0440

NPI assigned

May 4, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Maria Parham Physician Practices LLCGroup PAC ID 7719153683, 54 clinicians

Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maria Parham Medical Center Hospital, Henderson, NC, CCN 340132

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.pernell.1@20247.direct.athenahealth.com

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.

• DLP Maria Parham Physician Practices, LLC

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1215273628
  Medicare reassignment Care Compare group NPD
• DLP Maria Parham Physician Practices LLC

  • Rural Health Clinic/Center
  • Henderson, NC
  • NPI 1578256749
  NPD
• DLP Maria Parham Physician Practices, LLC

  • Orthopaedic Surgery Physician
  • Henderson, NC
  • NPI 1558750893
  NPD
• DLP Maria Parham Physician Practices, LLC

  • Physical Medicine & Rehabilitation Physician
  • Henderson, NC
  • NPI 1730466475
  NPD (past)

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

• DLP Maria Parham Medical Center LLC

  • General Acute Care Hospital
  • Henderson, NC
  • NPI 1164707725
  Care Compare affiliation
• DLP Maria Parham Medical Center LLC

  • Psychiatric Hospital Unit
  • Louisburg, NC
  • NPI 1689166605
  Care Compare affiliation

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1104515162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 KITTRELL RD",
            "city": "KITTRELL",
            "state": "NC",
            "postal_code": "275449013",
            "telephone_number": "125-243-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "252-436-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNELL",
        "first_name": "SAMANTHA",
        "middle_name": "CAROLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "287819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pelican Health Henderson LLC
• David Edward Peltier, D.O.
• Jill Holtzman Perkinson
• Kathryn Elizabeth Perkinson
• Leon Jackson Pernell Sr., LCAS
• Donna Perry, RN
• James Howard Perry, M.D.
• La'Shanda Michelle Person, LCASA
• Mary Frances Pettway, R.N.
• Philip D Meador Jr MD PA

• Nurse Practitioner in Henderson, NC
• Providers in Henderson, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.