NPIMap

Organization Active NPI

Sams Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Leslie, MI
National Provider Identifier
1306073945
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5501012063 Issued in MI
Legal business name
SAMS PHYSICAL THERAPY PC
Practice address
148 S. Main St.
Leslie, MI 49251-9426
Phone
(517) 589-9050
Fax
(517) 589-9053
NPI assigned
Jun 22, 2009
Last updated
Oct 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Authorized official

Name
Ranjith Samson, PT, DPTNPI 1417179367
Title
Owner
Phone
(517) 589-9050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5501012063 MI Primary

Addresses

Primary practice location

148 S. Main St.
Leslie, MI 49251-9426

Mailing address

P.O. Box 158
Leslie, MI 49251-0158
Phone (517) 589-9050

Other identifiers 1

IdentifierTypeStateIssuer
650C811890OtherMIBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120822000162 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0143372516 Practice locations: Charlotte, MI; Leslie, MI; Mason, MI
O20151210001853 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0143372516 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, MI; East Lansing, MI; Lansing, MI; Leslie, MI; Mason, MI

National Provider Directory

National Provider Directory

Locations

134 S Cochran Ave
Ste B
Charlotte, MI 48813
Phone (517) 541-1000

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1306073945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 158",
            "city": "LESLIE",
            "state": "MI",
            "postal_code": "492510158",
            "telephone_number": "517-589-9050",
            "fax_number": "517-589-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S. MAIN ST.",
            "city": "LESLIE",
            "state": "MI",
            "postal_code": "492519426",
            "telephone_number": "517-589-9050",
            "fax_number": "517-589-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "RANJITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-589-9050",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501012063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "650C811890",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leslie, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.