Individual provider Active NPI

Samuel Steven Floyd Jr., PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1285731299
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103440 Issued in NC
Practice address
11010 S Tryon St
Ste. 108
Charlotte, NC 28273-0106
Phone
(704) 583-1155
Fax
(704) 504-2495
NPI assigned
Sep 20, 2006
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103440 NC Primary

Addresses

Primary practice location

11010 S Tryon St
Ste. 108
Charlotte, NC 28273-0106

Mailing address

11010 S Tryon St
Ste. 108
Charlotte, NC 28273-0106
Phone (704) 583-1155

Other practice location 1

252 Turnersburg Hwy # Kwy
Statesville, NC 28625-2754
Phone (704) 818-0369

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
I20090220000553 NC Practitioner - Physician Assistant 8123183332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

1020 Tree of Life LN
Cornelius, NC 28031-9454
Phone (704) 801-8100

1361 Klumac Rd
Salisbury, NC 28147-9086
Phone (704) 603-1175

252 Turnersburg Hwy
Suite E
Statesville, NC 28625-2755
Phone (704) 818-0369

391 George W Liles Pkwy NW
Concord, NC 28027-8218
Phone (704) 886-1780

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Feb 23, 2026 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Feb 23, 2026 Accepting new patients
Solstas Lab Partners Group LLC Past Accepting new patients
Northeastern Orthopedics, PA PastSince Aug 14, 2000 Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients
Caromont Medical Group Inc Past Accepting new patients

Locations

11530 Providence Rd
Ste 1300
Charlotte, NC 28277
Phone (704) 667-0780

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1020 Tree of Life Ln
Cornelius, NC 28031
Phone (704) 801-7330

Organizations & group practices 8

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1285731299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11010 S TRYON ST",
            "address_2": "STE. 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730106",
            "telephone_number": "704-583-1155",
            "fax_number": "704-504-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 S TRYON ST",
            "address_2": "STE. 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730106",
            "telephone_number": "704-583-1155",
            "fax_number": "704-504-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 Turnersburg Hwy # Kwy",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286252754",
            "country_code": "US",
            "telephone_number": "704-818-0369",
            "fax_number": "704-878-8924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "SAMUEL",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.