Samantha Dietter, PA-C, CAQ-PSYCH

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11703 Issued in NC

Practice address

4011 Westchase Blvd Ste 225
Raleigh, NC 27607-3978

Phone

(919) 828-9937

Fax

(919) 828-4287

NPI assigned

Nov 4, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sdietter@psychiatric-associates-o.direct.kno2fy.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.

• Psychiatric Associates of NC, PA

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1154374825
  NPD (past)

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1386309342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 WESTCHASE BLVD STE 225",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073978",
            "telephone_number": "919-828-9937",
            "fax_number": "919-828-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 WESTCHASE BLVD STE 225",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073978",
            "telephone_number": "919-828-9937",
            "fax_number": "919-828-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETTER",
        "first_name": "SAMANTHA",
        "credential": "PA-C, CAQ-PSYCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee L Diehl, M.A. CCC-SLP
• Cynthia Lyn Diehl, M.D.
• Lee Harold Diehl, M.D.
• Nicolas Russell Diemma
• Paula M Dietrich, PHARMD
• Audrey Parsons Difilippo, MS, LCMHC
• Digestive Healthcare, PA
• Adena Kernes Diggs, MA, LCMHCA, NCC
• Ruth Norman Digiovanni, LCSW
• Digitrace Care Services Inc

• Physician Assistant in Raleigh, NC
• Providers in Raleigh, 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 Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.