Active NPI
Samuel Michael Stewart, P.T.A.
- Physical Therapy Assistant
- Gastonia, NC
National Provider Identifier
1023309465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2040
- Practice address
- 1351 Robinwood Rd
Gastonia, NC 28054-1693 - Phone
- (704) 867-2319
- NPI assigned
- Apr 19, 2011
- Last updated
- Apr 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2040 | NC | Primary |
Addresses
Primary practice location
1351 Robinwood Rd
Gastonia, NC 28054-1693
Mailing address
3711 Mitchem Rd
Gastonia, NC 28054-3090
Phone (704) 830-4296
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2040 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1023309465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3711 MITCHEM RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280543090",
"telephone_number": "704-830-4296",
"fax_number": "704-824-2939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 ROBINWOOD RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280541693",
"telephone_number": "704-867-2319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "SAMUEL",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "P.T.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "2040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.