NPIMap

Individual provider Active NPI

Samantha Blake Hicks, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1518390632
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5006361 Issued in NC
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-4490
NPI assigned
Aug 13, 2013
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5006361 NC Primary

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 291-6904

Other practice location 2

1237 Harding Pl
Ste 3200
Charlotte, NC 28204
Phone (704) 355-5375

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address shicks210627@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131216000897 NC Practitioner - Nurse Practitioner 9032346275 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians
Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

1237 Harding PL
Suite 4100
Charlotte, NC 28204-2826
Phone (704) 355-8816

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

1370 W D St
North Wilkesboro, NC 28659-3506
Phone (336) 651-8760

200 Medical Park Dr
Suite 550B
Concord, NC 28025-2982
Phone (704) 403-9177

2630 Willard Dairy Rd
Suite 200
High Point, NC 27265-8351
Phone (336) 884-3800

433 McAlister Rd
Lincolnton, NC 28092-4147
Phone (980) 212-2000

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
Carolinas Medical Center Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Sep 11, 2023 Accepting new patients
Moses Cone Medical Services, Inc. Nurse Practitioner CurrentSince Jan 20, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 9, 2017 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 21, 2024 Accepting new patients
Moses Cone Medical Services, Inc. CurrentSince Jan 20, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 21, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 9, 2017 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Sep 11, 2023 Accepting new patients
Carolinas Medical Center CurrentSince Oct 21, 2013 Accepting new patients
Scotland Regional Health Network CurrentSince Apr 9, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 21, 2024 Accepting new patients
Scotland Regional Health Network CurrentSince Apr 9, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Oct 21, 2013 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1237 Harding Pl
Ste 3200
Charlotte, NC 28204
Phone (704) 355-5375

1237 Harding Pl
Ste 4100
Charlotte, NC 28204
Phone (704) 355-8816

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

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

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

200 Medical Park Dr
Ste 550B
Concord, NC 28025
Phone (704) 403-9177

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

3511 W Market St
Greensboro, NC 27403
Phone (336) 522-8999

3518 Drawbridge Pkwy
Ste 220
Greensboro, NC 27410
Phone (336) 890-3020

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

2630 Willard Dairy Rd
#200
High Point, NC 27265
Phone (336) 884-3800

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Interoperability endpoints

  • Direct secure messaging: shicks210627@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: shicks502244@direct.conehealth.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1518390632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Lauchwood Dr",
            "address_purpose": "LOCATION",
            "city": "Laurinburg",
            "state": "NC",
            "postal_code": "283525501",
            "country_code": "US",
            "telephone_number": "910-291-6904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-355-5375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "SAMANTHA",
        "middle_name": "BLAKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shicks210627@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1350 S Kings Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282072134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.