Individual provider Active NPI

Samantha Leigh Shell

  • Physical Therapy Assistant
  • Kingsport, TN
National Provider Identifier
1265328215
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8907 Issued in TN
Practice address
2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone
(423) 765-9655
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8907 TN Primary

Addresses

Primary practice location

2300 Pavilion Dr
Kingsport, TN 37660-4622

Mailing address

226 Kent Rd
Jonesborough, TN 37659-5501
Phone (423) 268-7679

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
8907TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1265328215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 KENT RD",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376595501",
            "telephone_number": "423-268-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PAVILION DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604622",
            "telephone_number": "423-765-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELL",
        "first_name": "SAMANTHA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "8907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.