Mr Samuel Mark Shores, FNP-BC in Matthews, NC

Mr Samuel Mark Shores, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Matthews, North Carolina. His current practice location is 630 Matthews Township Pkwy, Matthews, North Carolina. You can reach out to his office (for appointments etc.) via phone at (704) 495-6020.

Mr Samuel Mark Shores is licensed to practice in North Carolina (license number 5015329) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1992477020.

Contact Information

	Mr Samuel Mark Shores, FNP-BC
	630 Matthews Township Pkwy, Matthews, NC 28105-5322
	(704) 495-6020
	(844) 620-0793

Map and Direction

Provider's Profile

Full Name	Mr Samuel Mark Shores
Gender	Male
Speciality	Nurse Practitioner - Family
Location	630 Matthews Township Pkwy, Matthews, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992477020
Provider Enumeration Date: 09/28/2021
Last Update Date: 01/27/2023

Medicare PECOS Information:

PECOS PAC ID: 8022401637
Enrollment ID: I20220203000203

Medical Identifiers

Medical identifiers for Mr Samuel Mark Shores such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992477020	NPI	-	NPPES
1992477020	Other	NC	5015329

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	5015329 (North Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Samuel Mark Shores allows following entities to bill medicare on his behalf.

Entity Name	Tryon Medical Partners, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992204549 PECOS PAC ID: 7113277971 Enrollment ID: O20180829002057

Entity Name	Amity Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003301300 PECOS PAC ID: 7618205980 Enrollment ID: O20190823002238

Entity Name	Monogram Health Professional Services Of North Carolina Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366162885 PECOS PAC ID: 9335517176 Enrollment ID: O20221129000129

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Samuel Mark Shores is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Samuel Mark Shores, FNP-BC 5960 Fairview Rd Ste 500, Charlotte, NC 28210-3113 Ph: (704) 495-6324	Mr Samuel Mark Shores, FNP-BC 630 Matthews Township Pkwy, Matthews, NC 28105-5322 Ph: (704) 495-6020

Reviews and Comments

Nurse Practitioner Nurses in Matthews, NC

Leah Brianne Kingswood, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1450 Matthews Township Pkwy Ste 350, Matthews, NC 28105 Phone: 704-841-8877
Ms. Lora Solomon, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3046b Senna Dr, Matthews, NC 28105 Phone: 704-841-3886 Fax: 704-841-3889
Olivia Hallingquest, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1305 Matthews Township Pkwy, Matthews, NC 28105 Phone: 704-846-7651
Amy Kay Parris, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1450 Matthews Township Pkwy Ste 250, Matthews, NC 28105 Phone: 704-841-1444 Fax: 704-849-2520
Lillian Sliwoski, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9705 Northeast Pkwy Ste 400, Matthews, NC 28105 Phone: 704-884-8971
Mrs. Heather Jean Mathew, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1401 Matthews Township Pkwy Ste 110, Matthews, NC 28105 Phone: 704-264-3500 Fax: 704-417-4989
Mrs. Gretchen Elaine Lawson, MSN, APRN, AGNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1122 Sam Newell Rd Ste 114, Matthews, NC 28105 Phone: 980-430-3130 Fax: 980-245-3433

Mr Samuel Mark Shores, FNP-BC - Medicare Nurse Practitioner in Matthews, NC