Willow Samsel, OT

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

OT002550 Issued in GA

Practice address

1230 Baxter St
Athens, GA 30606-3712

Phone

(706) 389-2950

NPI assigned

Sep 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Willow Frederick Former name

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1265868277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063712",
            "telephone_number": "706-389-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063712",
            "telephone_number": "706-389-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSEL",
        "first_name": "WILLOW",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "OT002550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003133503A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLOW",
            "last_name": "FREDERICK",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Holly Norwood Samples, RD, LD
• Craig Hirsch Sampson, M.D.
• Stacy Daniel Sampson, LPC
• Sams East Inc
• Walter A Sams IV, MD
• Danielle G Samsury
• Lauren Young Sanders, NP
• Lindsey Louise Moore Sanders
• Sheila J Sanders, PT
• Alice Mary Sanderson, CCC-A

• General Acute Care Hospital in Athens, GA
• Providers in Athens, GA by specialty
• General Acute Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.