Individual provider Active NPI

Samantha Parks, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1851077176
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LL90183 Issued in SC
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5871
Phone
(704) 355-7479
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL90183 SC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5871

Mailing address

1000 Blythe Blvd
Charlotte, NC 28203-5871

Other practice location 1

169 Ashley Ave
Room 202 Main Hospital MSC333
Charleston, SC 29425-8905
Phone (843) 876-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229000772 SC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6204271257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL90183SCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1851077176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035871",
            "telephone_number": "704-355-7479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 Main Hospital MSC333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-876-0888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKS",
        "first_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL90183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.