Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Nicole Southern

Individual provider Nurse Practitioner · NPI 1508601402

Samantha Nicole Southern is a Nurse Practitioner in Winston Salem, North Carolina. Qualified in 2025, 1 year ago. Practices with Nh-Cl Clinics LLC, a 83-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
1
Licensed in
NC
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

2810 Maplewood Ave
Winston Salem, NC 27103-4138
Phone: (336) 860-6194
Fax: (336) 860-6236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5023108 (NC)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F07250035 (NC)

Record details

NPI number1508601402
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 1, 2024
Last updated in NPPESApril 15, 2026
Certification dateApril 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Nh-Cl Clinics Llc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Winston Salem