Active NPI
Samantha Lynn Higginbothem, OTR/L
- Pediatric Occupational Therapist
- Frederick, MD
National Provider Identifier
1265100341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 09328
- Practice address
- 5104 Pegasus CT Ste B
Frederick, MD 21704-8323 - Phone
- (443) 776-0271
- NPI assigned
- Sep 2, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 09328 | MD | Primary |
Addresses
Primary practice location
5104 Pegasus CT Ste B
Frederick, MD 21704-8323
Mailing address
101 Leather Fern Way
Frederick, MD 21702-4474
Phone (301) 305-2482
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 |
|---|---|---|---|
| 09328 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1265100341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 LEATHER FERN WAY",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024474",
"telephone_number": "301-305-2482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5104 PEGASUS CT STE B",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217048323",
"telephone_number": "443-776-0271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGINBOTHEM",
"first_name": "SAMANTHA",
"middle_name": "LYNN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-02",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MD",
"license": "09328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.