Samaritan Sports Medicine PLLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

SAMARITAN SPORTS MEDICINE PLLC

Practice address

8300 Falls of Neuse Rd Ste 110
Raleigh, NC 27615-3450

Phone

(919) 648-0618

NPI assigned

Aug 22, 2025

Last updated

Aug 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Martin Petty, MDNPI 1518252105

Title

Owner

Phone

(919) 648-0618

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Martin Petty, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Durham, NC
  • NPI 1518252105
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1407734031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 FALLS OF NEUSE RD STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153450",
            "telephone_number": "919-648-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 FALLS OF NEUSE RD STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153450",
            "telephone_number": "919-648-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-648-0618",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Sports Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.