Sampson Ray Booth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4311 Old Ocean Hwy
Bolivia, NC 28422-8637

Phone

(877) 935-5255

NPI assigned

Aug 6, 2025

Last updated

Aug 6, 2025By the provider in NPPES

Sex

Male

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

Physician Assistant

Education

Campbell Univ School of Osteopathic Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri County Community Health Council IncGroup PAC ID 2163409558, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Tri County Community Health Council Inc

  • Federally Qualified Health Center (FQHC)
  • Four Oaks, NC
  • NPI 1427087709
  Medicare reassignment Care Compare group
• Tri County Community Health Council Inc

  dba CommWell Health

  • Adult Mental Health Clinic/Center
  • Dunn, NC
  • NPI 1790270999
  NPD
• Tri County Community Health Council Inc

  • Federally Qualified Health Center (FQHC)
  • Bolivia, NC
  • NPI 1992171060
  NPD

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

• Brunswick Community Hospital, LLC

  dba Novant Health Brunswick Medical Center

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  Care Compare affiliation

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1306721808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 RAMSEUR JULIAN RD",
            "city": "LIBERTY",
            "state": "NC",
            "postal_code": "272988606",
            "telephone_number": "336-588-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 OLD OCEAN HWY",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228637",
            "telephone_number": "877-935-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "SAMPSON",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandana Bhimmanapalli, MD
• Nicholas Proch Billings, DO
• Blissful Beginnings Therapy Group PLLC
• Alan Joseph Bloszko Jr, MD
• Nicholas Barrett Bodenheimer, DO
• Roberta Samelson Bracken, M.D.
• Heather C Braithwaite, MD
• Christopher Adams Brann, MD
• Justin Bridge
• Nicholas Matthew Brooker, PT, DPT

• Physician Assistant in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.