Individual provider Active NPI

Samantha Ericksen, PA-C

  • Physician Assistant
  • Asheville, NC
National Provider Identifier
1679071773
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10788 Issued in NC
Practice address
136 Charlotte Hwy
Asheville, NC 28803-9624
Phone
(828) 296-0880
Fax
(828) 296-0855
NPI assigned
Jan 24, 2018
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL
Physician Assistant 363A00000X 0010-10788 NC Primary

Addresses

Primary practice location

136 Charlotte Hwy
Asheville, NC 28803-9624

Mailing address

PO Box 96860
Charlotte, NC 28296-6860
Phone (828) 296-0880

Other practice location 1

11513 N Main St
Jacksonville, FL 32218-4002
Phone (904) 751-6200

Other identifiers 1

IdentifierTypeStateIssuer
1150959OtherNCNCCPA

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
I20201219000018 NC Practitioner - Physician Assistant 0042571606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RDMG Associates PAGroup PAC ID 9537442215, 27 clinicians

Practice addresses (Care Compare)

136 Charlotte Hwy
Asheville, NC 28803-9624
Phone (828) 296-0880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-10788NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
RDMG Associates PA Physician Assistant CurrentSince Nov 23, 2020 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 28, 2019 Accepting new patients
RDMG Associates PA Physician Assistant Past Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

11513 N Main St
Jacksonville, FL 32218
Phone (904) 751-6200

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

136 Charlotte Hwy
Asheville, NC 28803
Phone (828) 296-0880

10620 Park Rd
Ste 128
Charlotte, NC 28210
Phone (704) 542-6111

Interoperability endpoints

  • Direct secure messaging: samanthaericksen@fcfpa.allscriptsdirect.net

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

Hospital & facility affiliations 4

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": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1679071773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966860",
            "telephone_number": "828-296-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CHARLOTTE HWY",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288039624",
            "telephone_number": "828-296-0880",
            "fax_number": "828-296-0855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11513 N Main St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322184002",
            "country_code": "US",
            "telephone_number": "904-751-6200",
            "fax_number": "904-751-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1150959",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.