Individual provider Active NPI

Dawn M. Sampson, PA

  • Physician Assistant
  • Leland, NC
National Provider Identifier
1871676494
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001002455 Issued in NC
Practice address
9101 Ocean Hwy E
Leland, NC 28451
Phone
(910) 341-3300
Fax
(910) 251-2067
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001002455 NC Primary

Addresses

Primary practice location

9101 Ocean Hwy E
Leland, NC 28451

Mailing address

4222 Long Beach Rd SE
Southport, NC 28461-8627
Phone (910) 454-4732

Other names 1

  • Mrs. Dawn M. Blakemore Former name

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
I20110223000320 NC Practitioner - Physician Assistant 4183625072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
86.13
Improvement activities
40
Cost
79.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001002455NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince Sep 5, 2018 Accepting new patients
Wilmington Health PLLC CurrentSince Sep 5, 2018 Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients

Locations

9101 Ocean Hwy E
Leland, NC 28451
Phone (910) 343-5464

4222 Long Beach Rd SE
Southport, NC 28461
Phone (910) 269-2053

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

Organizations & group practices 4

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1871676494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 LONG BEACH RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618627",
            "telephone_number": "910-454-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 OCEAN HWY E",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "28451",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "DAWN",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001002455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "BLAKEMORE",
            "middle_name": "M.",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.