Samantha O'Daniel

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2016003532 Issued in MO

Practice address

10435 Clayton Rd
Frontenac, MO 63131-2931

Phone

(314) 442-6249

NPI assigned

Feb 10, 2016

Last updated

Feb 10, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Samantha Poteet Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1053779629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282",
            "telephone_number": "618-651-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 CLAYTON RD",
            "city": "FRONTENAC",
            "state": "MO",
            "postal_code": "631312931",
            "telephone_number": "314-442-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DANIEL",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016003532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "POTEET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Nicole Mahoney, RD
• Lauren McGaughey, PA-C
• Melanie Melissa Miranda, WHNP-BC
• Nra-St. Louis (Home Therapy Center), Missouri, LLC (Frontenac Home Dialysis Center)
• Nutriformance
• Jodi Otis, MPT, ATC
• Eleanor Bridget Perkins, LPC, NCC
• Samantha R Porter, PT, DPT, LMT, CMTPT
• Drew Rapert, DC
• Evan J Reed, D.D.S.

• Physical Therapist in Frontenac, MO
• Providers in Frontenac, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.