SAMANTHA WENNERBERG (NPI# 1083859482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083859482 |
| Entity Type | Individual |
| Full Name | SAMANTHA WENNERBERG |
| Credential | PA-C |
| Practice Address |
234 Crooked Creek Pkwy Durham NC 27713-8505 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 2034320092 |
| Mailing Telephone | 9196204918 |
| Mailing Fax Number | 9196204921 |
| Enumeration Date | 2008-12-14 |
| Last Update Date | 2019-05-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
001005699 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-05699 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367A00000X | Advanced Practice Midwife | 2183 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
234 CROOKED CREEK PKWY |
| City | DURHAM |
| State | NC |
| Zip Code | 27713-8505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306171 | Annika Marie Wilson | Speech-Language Pathologist | 234 Crooked Creek Pkwy, Durham, NC 27713-8505 | 2020-08-11 |
| 1215586680 | Lauren Vukin | Occupational Therapist | 234 Crooked Creek Pkwy, Durham, NC 27713-8505 | 2019-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1194352542 | Mariah Davis | Counselor | 1822 East Hwy Nc 54, Suite 300, Durham, NC 27713 | 2020-03-25 |
| 1316589138 | Monarch | Community/Behavioral Health | 1513 Piperwood Court, Durham, NC 27713 | 2019-10-14 |
| 1205486081 | Lisa Mesmer Barnes | Nurse Practitioner | 5309hwy 55, Suite 105, Durham, NC 27713 | 2019-09-13 |
| 1497315352 | Mary Therese Wood | Social Worker | 1822 E Highway 54, Suite 300, Durham, NC 27713 | 2019-06-13 |
| 1720558307 | Kevin D Simmons | Counselor | 1822 Nc Hwy 54 Suite 300, Durham, NC 27713 | 2018-11-27 |
| 1790265585 | Kelli Cryer | Counselor | 54 E Nc Hwy 1822, Suite 300, Durham, NC 27713 | 2018-08-21 |
| 1477039253 | Mahavir Rx, LLC | Pharmacy | 6216 Fayetteville Rd Ste 105, Durham, NC 27713 | 2018-07-16 |
| 1811482862 | Tessa Taylor | Dentist | 2515 E Nc Highway 54 Ste 2000, Durham, NC 27713 | 2018-06-22 |
| 1013401579 | Emily Louise Haller | Counselor | 1822 E Hwy 54, Suite 300, Durham, NC 27713 | 2018-06-19 |
| Find all providers in zip 27713 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083197651 | Erika Cummings | Physician Assistant | 40 Medicine Circle Clinic 1l Duke South Clinic Bldg, Durham, NC 27710-2102 | 2018-09-10 |
| 1396237566 | Sarah Elizabeth Beatty | Physician Assistant | 1317 Southpoint Crossing Dr, Durham, NC 27713 | 2018-06-04 |
| 1225548704 | Lindsey Anna Rowe | Physician Assistant | 2301 Erwin Road Duke North Suite 2600, Room 2607a, Durham, NC 27710-0001 | 2017-10-10 |
| 1801316831 | Stefanie Nikoloas Xenakis | Physician Assistant | 2400 Broad St Ste 1, Durham, NC 27704-2662 | 2017-06-21 |
| 1861842700 | Kelly Michelle Young | Physician Assistant | 2424 Erwin Rd Ste 201, Durham, NC 27705-3825 | 2016-06-21 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1033589577 | Andrew David Mcgraw | Physician Assistant | Duke University Medical Center Emergency, 2nd Floor 2301 Erwin Road Durham, Nc 27710, Durham, NC 27710-4699 | 2015-09-27 |
| 1093145443 | Catherine Casey Mcknight | Physician Assistant | 3458 Duke University Medical Center, Durham, NC 27710 | 2013-11-21 |
| 1013343490 | Carolyn Chyu Tashie | Physician Assistant | Duke Cancer Center 20 Duke Medicine Circle Clinic 3-2, Durham, NC 27710-4699 | 2013-09-18 |
| 1477817203 | Andrew Robert Macknair | Physician Assistant | 4225 Larchmont Rd, Apt 1021, Durham, NC 27707-5962 | 2012-06-26 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.