Shiny Samuel, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5010430 Issued in NC

Practice address

550 New Waverly PL Ste 105
Cary, NC 27518-7412

Phone

(919) 233-2022

NPI assigned

Apr 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cary Medical Clinic, PC

  • Internal Medicine Physician
  • Cary, NC
  • NPI 1184751372
  Medicare reassignment NPD
• Duke University Health System, Inc.

  • General Acute Care Hospital
  • Durham, NC
  • NPI 1992703540
  NPD (past)

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1689170375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DEER ISLE CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196465",
            "telephone_number": "919-946-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 NEW WAVERLY PL STE 105",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187412",
            "telephone_number": "919-233-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SHINY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5010430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Safadi DDS Ms PLLC
• Sujana Samala, MD
• Priyan Samarakoon, MD
• Samaritan Housing Foundation, Inc
• Samuel J. Deangelo
• Michael Andrew Samuels, OD
• Stuart L. Samuels, OD
• Ramatu Kadie Samura, LCMHCA, NCC
• Radwa Sherif Samy
• Tatianna Sanabria, MACOM, LAC

• Primary Care Nurse Practitioner in Cary, NC
• Providers in Cary, NC by specialty
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.