Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Samaritan Sports Medicine PLLC

Organization Sports Medicine (Family Medicine) Physician · NPI 1407734031

Samaritan Sports Medicine PLLC provides Sports Medicine (Family Medicine) Physician services in Raleigh, North Carolina. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8300 Falls Of Neuse Rd Ste 110
Raleigh, NC 27615-3450
Phone: (919) 648-0618
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1407734031
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Benjamin Petty — Owner · (919) 648-0618
NPI enumeratedAugust 22, 2025
Last updated in NPPESAugust 22, 2025
Certification dateAugust 22, 2025
Mailing address8300 Falls Of Neuse Rd Ste 110, Raleigh, NC 27615-3450

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