Samantha Maxine Wade, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

216677 Issued in TX

Practice address

3200 Parkway Rd
Big Spring, TX 79720-6800

Phone

(432) 263-4041

NPI assigned

Feb 1, 2021

Last updated

Feb 1, 2021By the provider in NPPES

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 names 1

• Samantha Maxine Lyon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Senior Connections of Texas, PLLC

  • Clinical Psychologist
  • Austin, TX
  • NPI 1831368703
  NPD (past)
• VCKB Management, LTD

  dba Parkview Nursing & Rehab Center

  • Skilled Nursing Facility
  • Big Spring, TX
  • NPI 1396723789
  NPD (past)

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1275124257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LOUISIANA AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797016046",
            "telephone_number": "817-944-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PARKWAY RD",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797206800",
            "telephone_number": "432-263-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "SAMANTHA",
        "middle_name": "MAXINE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LYON",
            "middle_name": "MAXINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• VCKB Management, LTD (Parkview Nursing & Rehab Center)
• Shelley Colene Vela
• Vibrant Mental Wellness LLC
• Juan Vigoa
• Alayna Marie Vise, AU.D., CCC-A
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0513)
• Wal-Mart Stores Texas, LP (Vision Center 30-0513)
• Alyssa Wanner, PHARMD
• Ward Family Dental, PC
• David L. Ward, D.D.S.

• Occupational Therapy Assistant in Big Spring, TX
• Providers in Big Spring, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.