Samyra Renee Wooten, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11523 Issued in NC

Practice address

2828 Maplewood Ave
Ste a
Winston Salem, NC 27103-4138

Phone

(336) 765-4703

Fax

(336) 765-1396

NPI assigned

Sep 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samyra Renne Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Austin-Caputo Physical Therapy Services, Inc.

  • Physical Therapist
  • Winston Salem, NC
  • NPI 1235175340
  NPD (past)
• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1558598532
  NPD (past)

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1295984755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SYMI CIR",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574309",
            "telephone_number": "252-247-2738",
            "fax_number": "252-240-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 MAPLEWOOD AVE",
            "address_2": "STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034138",
            "telephone_number": "336-765-4703",
            "fax_number": "336-765-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "SAMYRA",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMYRA",
            "last_name": "JOHNSON",
            "middle_name": "RENNE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie Jo Woosley, DPT
• Aaron Wooten, PT, PA-C
• Bobby Gene Wooten, DDS
• Daria Wuycik Wooten, RPH
• Robert E. Wooten, P.A.
• Jennifer Lea Worischeck, OTR
• Brady Stephen Workman, AUD
• Claude Raymond Workman, M.D.
• Robert D Worley
• Tomeka Wormack, NP

• All providers in Winston Salem, NC
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.