Individual provider Active NPI

Helene Kathrine Samudio, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1902309453
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010201 Issued in NC
Practice address
2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone
(980) 505-0957
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5010201 NC Primary

Addresses

Primary practice location

2340 Spring Forest Rd
Raleigh, NC 27615-7528

Mailing address

2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone (980) 505-0957

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
I20220713003929 NC Practitioner - Nurse Practitioner 9234510850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

2340 Spring Forest Rd
Raleigh, NC 27615-7528
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care North Carolina PLLC Family CurrentSince Aug 25, 2025 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Aug 25, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Mar 31, 2022 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

1142 N Broome St
Waxhaw, NC 28173
Phone (701) 843-4680

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1902309453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157528",
            "telephone_number": "980-505-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157528",
            "telephone_number": "980-505-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDIO",
        "first_name": "HELENE",
        "middle_name": "KATHRINE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.