Samuel Archino Jr., FNP-BC – Nurse Practitioner

Key facts

NPI: 1649005877
Entity type: Individual (NPI type 1)
Primary specialty: Nurse Practitioner 363L00000X
License: 5020874 (NC)
Practice address: 317 Western Blvd
Jacksonville, NC 28546-6338
Phone: (910) 577-2345
NPI assigned: Sep 6, 2024
Sex: Male
Sole proprietor: No

Organizations & group practices 3

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.

Tarheel Emergency Group, PLLC Emergency Medicine Physician · Jacksonville, NC · NPI 1386388874

Medicare reassignment Care Compare group NPD NC
Lifesource of North Carolina Internal Medicine Physician · Wilmington, NC · NPI 1811286156

Medicare reassignment NC
Lifesource Prime Inc Family Medicine Physician · Wilmington, NC · NPI 1598533275

Medicare reassignment NC

Hospital & facility affiliations 1

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

Onslow Memorial Hospital Inc General Acute Care Hospital · Jacksonville, NC · NPI 1679535496

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2024
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Tarheel Emergency Group, PLLC (40 clinicians)

Practice addresses (Care Compare)

317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345

Hospital & facility affiliations

Onslow Memorial Hospital Hospital · Jacksonville, NC · CCN 340042

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20241016001018	NC	Practitioner - Nurse Practitioner	6901338938	Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
235585	NC	MD	Emergency Registered Nurse
5020874	NC	MD	Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Tarheel Emergency Group, PLLC		Current since Sep 17, 2024	Accepting new patients

Locations

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

Interoperability endpoints

FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse Practitioner	363L00000X	5020874	NC	Yes
Emergency Registered Nurse	163WE0003X	235585	NC

Addresses

Primary practice location

317 Western Blvd
Jacksonville, NC 28546-6338

Mailing address

PO Box 821
Swansboro, NC 28584-0821
Phone (252) 702-5279

Other practice location 1

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

Other providers in Jacksonville, NC

All providers in Jacksonville, NC · Nurse Practitioner in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.