Individual provider Active NPI

Samantha E Borden, PNP

  • Pediatric Nurse Practitioner
  • Sanford, NC
National Provider Identifier
1962696740
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
167378 Issued in NC
Practice address
1301 Central Dr
Sanford, NC 27330-4159
Phone
(919) 718-9512
Fax
(919) 718-9516
NPI assigned
Sep 5, 2007
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 167378 NC Primary

Addresses

Primary practice location

1301 Central Dr
Sanford, NC 27330-4159

Mailing address

143 W Franklin St
Chapel Hill, NC 27516-2539
Phone (919) 966-8596

Other practice location 1

101 Manning Dr
Chapel Hill, NC 27599-0001
Phone (919) 966-8596

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sborden31961@direct.UNC.nchie.net Direct

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
I20071110000066 NC Practitioner - Nurse Practitioner 4284722117 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300227NCMDGeneral Practice Registered Nurse
167378NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Apr 11, 2017 Accepting new patients
Unc Physicians Network LLC CurrentSince Feb 15, 2024 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Apr 11, 2017 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

1301 Central Dr
Sanford, NC 27330
Phone (919) 718-9512

Interoperability endpoints

  • Direct secure messaging: sborden31961@direct.unc.nchie.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1962696740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 W FRANKLIN ST",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275162539",
            "telephone_number": "919-966-8596",
            "fax_number": "919-843-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CENTRAL DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304159",
            "telephone_number": "919-718-9512",
            "fax_number": "919-718-9516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-8596",
            "fax_number": "919-843-5515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORDEN",
        "first_name": "SAMANTHA",
        "middle_name": "E",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "167378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sborden31961@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1301 Central Dr",
            "city": "Sanford",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273304159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.