Socheathdara Sam

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306606194 Issued in VA

Practice address

4040 Fairfax Dr Ste 120
Arlington, VA 22203-1613

Phone

(571) 777-0918

NPI assigned

Feb 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1063166692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 GALLOWS RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031450",
            "telephone_number": "301-979-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 FAIRFAX DR STE 120",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031613",
            "telephone_number": "571-777-0918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6355 Walker Ln Ste 512",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223103251",
            "country_code": "US",
            "telephone_number": "635-551-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "SOCHEATHDARA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-11",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606194",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashida Saleem
• Rania Saleh, DDS, MSD
• Assad T Saliba, RPH
• Fatimah Jihad Salim, LPTA
• Cristina Yanez Salinas, RN
• Rasoul Samadani, PHARM.D
• Samer Cheaib
• Ana Gabriella Sammon
• Keeran Ravin Sampat, MD
• Nicole R Sampson, PHD

• Physical Therapy Assistant in Arlington, VA
• Providers in Arlington, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.