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SAMUEL H WEATHERFORD PA-C
NPI 1508075896
Physician Assistant - Medical in Wallace, NC

Active since May 22, 2007PECOS EnrolledAccepts Medicare Assignment
112 MEDICAL VILLAGE DR STE F, WALLACE, NC 28466(910) 285-0940(910) 285-1825 Get Directions Write a Review

NPPES record last updated: July 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 26, 2024, Apr 10, 2024, Jun 11, 2021 and 3 more (6 updates tracked since 2021).

About Samuel H Weatherford Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL H WEATHERFORD PA-C (NPI 1508075896) is an individual medical provider in Wallace, North Carolina, licensed in North Carolina (0010-05179) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Onslow Memorial Hospital, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1508075896
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameSAMUEL H WEATHERFORDCredential: PA-C
Location Address112 MEDICAL VILLAGE DR STE FWallace, NC 28466-1665
Mailing Address112 Medical Village Dr Ste FWallace, NC 28466-1665 · (910) 285-0940 · Fax (910) 285-1825
Phone(910) 285-0940
Fax(910) 285-1825
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMay 22, 2007
Last NPPES UpdateJuly 26, 20246 updates tracked since enumeration
NPPES CertifiedJuly 26, 2024
✔ NPI 1508075896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NC · 0010-05179
Also ListedPhysician AssistantTaxonomy 363A00000X · License 0010-05179 (NC)
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 656 (SC)
112 MEDICAL VILLAGE DR STE F, Wallace, NC 28466
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel H Weatherford Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961815089
PECOS Enrollment IDI20210111001511
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Onslow Memorial Hospital

Acute Care Hospitals · Jacksonville, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340042
Location317 Western BoulevardJacksonville, NC 28540 · Onslow County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PREMISE HEALTH OF NORTH CAROLINA MEDICAL PC
Clinic/Center (Primary Care)
112 MEDICAL VILLAGE DR STE F
WALLACE, NC 28466
Duplin County (910) 285-0940
PO POWELL MANAGEMENT GROUP, LLC
Internal Medicine
112 MEDICAL VILLAGE DR STE F
WALLACE, NC 28466
Duplin County (910) 665-1780

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Weatherford's NPI number?

The NPI number for Samuel Weatherford is 1508075896. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Samuel Weatherford located?

Samuel Weatherford practices at 112 Medical Village Dr Ste F, Wallace, NC 28466. The listed phone number is (910) 285-0940.

What is Samuel Weatherford's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Samuel Weatherford enrolled in Medicare?

Yes. Samuel Weatherford is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samuel Weatherford accept?

Health plans from AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC list Samuel Weatherford as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samuel Weatherford affiliated with any hospitals?

According to CMS data, Samuel Weatherford is affiliated with Onslow Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Samuel Weatherford was last updated on July 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.