Active NPI
Samantha Joelle Rushton, PA-C
- Physician Assistant
- Lillington, NC
National Provider Identifier
1295154805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001004756
- Practice address
- 100 S 10TH St Ste B
Lillington, NC 27546-6690 - Phone
- (910) 984-8229
- Fax
- (910) 514-9717
- NPI assigned
- Apr 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001004756 | NC | Primary |
Addresses
Primary practice location
100 S 10TH St Ste B
Lillington, NC 27546-6690
Mailing address
PO Box 647
Attn: Credentialing Department
Hope Mills, NC 28348-0647
Phone (910) 483-7337
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295154805 | Other | NC | DOCTORS DIRECT |
| 1295154805 | Medicaid | NC | |
| 1461976 | Other | NC | WELLPATH |
| 186WS | Other | NC | BCBS OF NC |
| FH4001720 | Other | NC | FIRST CAROLINA CARE |
| 4302372 | Other | NC | COVENTRY NATIONAL PPO |
| 251128 | Other | NC | MEDCOST, LLC |
| 4341301 | Other | NC | UNITED HEALTHCARE |
| 4741883 | Other | NC | AETNA |
| 5678738 | Other | NC | CIGNA/GREATWEST |
| 13356163 | Other | NC | PHCS/MULTIPLAN |
| 1461976 | Other | NC | COVENTRY OF NC |
| 1295154805 | Other | NC | HEALTHNET FEDERAL SERVICES |
| 1295154805 | Other | NC | HUMANA |
| 1295154805 | Other | NC | HEALTHSMART |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001004756 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidzcare Pediatrics, PC | Past | Accepting new patients | |
| Kidzcare Pediatrics, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Lillington, NC
- NPI 1023420973
-
- Pediatrics Physician
- Hope Mills, NC
- NPI 1679529051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1295154805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 647",
"address_2": "ATTN: CREDENTIALING DEPARTMENT",
"city": "HOPE MILLS",
"state": "NC",
"postal_code": "283480647",
"telephone_number": "910-483-7337",
"fax_number": "910-483-0648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S 10TH ST STE B",
"city": "LILLINGTON",
"state": "NC",
"postal_code": "275466690",
"telephone_number": "910-984-8229",
"fax_number": "910-514-9717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSHTON",
"first_name": "SAMANTHA",
"middle_name": "JOELLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-10",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001004756",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS DIRECT",
"identifier": "1295154805",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1295154805",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "1461976",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "186WS",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CAROLINA CARE",
"identifier": "FH4001720",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY NATIONAL PPO",
"identifier": "4302372",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST, LLC",
"identifier": "251128",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "4341301",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4741883",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA/GREATWEST",
"identifier": "5678738",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS/MULTIPLAN",
"identifier": "13356163",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY OF NC",
"identifier": "1461976",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET FEDERAL SERVICES",
"identifier": "1295154805",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "1295154805",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSMART",
"identifier": "1295154805",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lillington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.