Individual provider Active NPI

Samantha Powell

  • Occupational Therapist
  • Palm City, FL
National Provider Identifier
1114275732
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT25129 Issued in FL
Practice address
2684 SW Immanuel Dr
Palm City, FL 34990-2738
Phone
(772) 291-2179
NPI assigned
Aug 29, 2012
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT25129 FL Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

2684 SW Immanuel Dr
Palm City, FL 34990-2738

Mailing address

5691 SE Hull St
Stuart, FL 34997-2406
Phone (772) 595-4858

Other practice location 1

2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309
Phone (772) 489-4726

Other practice location 2

2806 S US Highway 1 Ste C7
Fort Pierce, FL 34982-8109
Phone (772) 467-5550

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

LicenseStateTypeSpecialty
OT25129FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Links, LLC Single Specialty CurrentSince Mar 17, 2024 Accepting new patients

Locations

2684 SW Immanuel Dr
Palm City, FL 34990
Phone (772) 220-3444

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1114275732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5691 SE HULL ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349972406",
            "telephone_number": "772-595-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2684 SW IMMANUEL DR",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902738",
            "telephone_number": "772-291-2179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Colonial Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349505309",
            "country_code": "US",
            "telephone_number": "772-489-4726",
            "fax_number": "772-489-0423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2806 S US Highway 1 Ste C7",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349828109",
            "country_code": "US",
            "telephone_number": "772-467-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT25129",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.