Individual provider Active NPI

Samuela Amara Fernandes

  • Student in an Organized Health Care Education/Training Program
  • Durham, NC
National Provider Identifier
1770163610
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3000 Erwin Rd
Durham, NC 27705-4504
Phone
(919) 684-6669
NPI assigned
Apr 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3000 Erwin Rd
Durham, NC 27705-4504

Mailing address

3000 Erwin Rd
Durham, NC 27705-4504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250429003822 NC Order and Referring Only - Medical Genetics and GenomicsPractitioner - Medical Genetics and Genomics 6305362690
I20260216001722 NC Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6305362690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center PastSince Apr 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1770163610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054504",
            "telephone_number": "919-684-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "SAMUELA",
        "middle_name": "AMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.