Individual provider Active NPI

Samantha Nicole Chesson Davis, FNP

  • Family Nurse Practitioner
  • Washington, NC
National Provider Identifier
1639785074
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5013588 Issued in NC
Practice address
853 Washington Square Mall
Washington, NC 27889-3530
Phone
(252) 623-2000
NPI assigned
Sep 21, 2020
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5013588 NC Primary

Addresses

Primary practice location

853 Washington Square Mall
Washington, NC 27889-3530

Mailing address

1280 Tall Timbers E
Williamston, NC 27892-7202
Phone (252) 799-9128

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
I20210903002390 NC Practitioner - Nurse Practitioner 8022414747 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Providers of America LLCGroup PAC ID 9931529948, 97 clinicians

Practice addresses (Care Compare)

11230 Ballantyne Trace CT
Charlotte, NC 28277-2791
Phone (704) 544-7220

1280 Tall Timbers LN E
Williamston, NC 27892-7202
Phone (919) 345-8488

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5013588NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Topfeet Foot and Wound Care PLLC Family CurrentSince Jun 3, 2025 Accepting new patients
Urgent Care Down East Inc CurrentSince Jul 30, 2021 Accepting new patients
Health Providers of America, LLC CurrentSince Jan 1, 2025 Accepting new patients
Williamston Clinic Corp CurrentSince May 23, 2022 Accepting new patients
Tophealth and Wellness, PLLC Family PastSince Sep 27, 2020 Accepting new patients

Locations

11230 Ballantyne Trace Ct
Charlotte, NC 28277
Phone (704) 341-1139

501 N Main St
Robersonville, NC 27871
Phone (252) 284-3501

853 Washington Square Mall
Washington, NC 27889
Phone (252) 623-2000

104 Medical Dr
Williamston, NC 27892
Phone (252) 809-6300

232 Green St
Williamston, NC 27892
Phone (252) 792-6611

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1639785074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 TALL TIMBERS E",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278927202",
            "telephone_number": "252-799-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 WASHINGTON SQUARE MALL",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893530",
            "telephone_number": "252-623-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESSON DAVIS",
        "first_name": "SAMANTHA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.