Individual provider Active NPI

Samantha Marie Vance, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1619744208
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14136 Issued in NC
Practice address
2165 Medical Park Dr
Hickory, NC 28602-8809
Phone
(828) 324-2800
NPI assigned
Dec 5, 2023
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-14136 NC Primary

Addresses

Primary practice location

2165 Medical Park Dr
Hickory, NC 28602-8809

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Other practice location 1

829 W 25th St
Newton, NC 28658-2852
Phone (828) 464-3771

Other practice location 2

3900 Terrell Park Dr
Sherrills Ford, NC 28673-9509
Phone (828) 580-1331

Other identifiers 1

IdentifierTypeStateIssuer
0010-14136OtherNCMEDICAL LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240517000515 NC Practitioner - Physician Assistant 8022459395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

2165 Medical Park Dr
Hickory, NC 28602-8809
Phone (828) 324-2800

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

829 W 25TH St
Newton, NC 28658-2852
Phone (828) 464-3771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Apr 3, 2024 Accepting new patients
Emergeortho PA CurrentSince Apr 3, 2024 Accepting new patients

Locations

2165 Medical Park Dr
Hickory, NC 28602
Phone (828) 294-7793

829 W 25th St
Newton, NC 28658
Phone (828) 332-2088

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: samantha.vance.1@847.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1619744208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 MEDICAL PARK DR",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028809",
            "telephone_number": "828-324-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 W 25th St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "NC",
            "postal_code": "286582852",
            "country_code": "US",
            "telephone_number": "828-464-3771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 Terrell Park Dr",
            "address_purpose": "LOCATION",
            "city": "Sherrills Ford",
            "state": "NC",
            "postal_code": "286739509",
            "country_code": "US",
            "telephone_number": "828-580-1331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCE",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "0010-14136",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.