Individual provider Active NPI

Samantha Lynn Smith, NNP-BC

  • Critical Care Neonatal Nurse Practitioner
  • Durham, NC
National Provider Identifier
1154009926
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
5018423 Issued in NC
Practice address
2301 Erwin Rd
Durham, NC 27705-4699
Phone
(919) 684-8111
NPI assigned
Jul 10, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 5018423 NC Primary

Addresses

Primary practice location

2301 Erwin Rd
Durham, NC 27705-4699

Mailing address

5647 Stewart Rd
Wade, NC 28395-8939
Phone (919) 935-6106

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230818002601 NC Practitioner - Nurse Practitioner 3870955008 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5018423NCMDCritical Care Neonatal Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: smalatestinic218727@direct.medicine.duke.edu

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1154009926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5647 STEWART RD",
            "city": "WADE",
            "state": "NC",
            "postal_code": "283958939",
            "telephone_number": "919-935-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054699",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "NNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NC",
            "license": "5018423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.