Samantha Skeen Church

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5016609 Issued in NC

Practice address

Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(363) 713-6428

Fax

(336) 716-2525

NPI assigned

Jul 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: schurch2753347@carolinashealthcaresystem.direct-ci.com

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1730814922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "363-713-6428",
            "fax_number": "336-716-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "SAMANTHA",
        "middle_name": "SKEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016609",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NC",
            "license": "104851799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Chung, MD
• Hoyoon Chung
• Juliet Chung, MD
• Kevin Minwoo Chung, PA-C
• Sarah Michelle Chupita, NNP-BC
• Sarah Serrano Chwialkowski, NP
• Cole James Cibu, PA-C
• Teresa Ann Cicci, PHARMD
• Nicole Isabel Cillis, DO
• Sarah Nicole Cilvik, MD,PHD

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.