Individual provider Active NPI

Samantha Marie Rawson, LMT

  • Massage Therapist
  • Mattydale, NY
National Provider Identifier
1306316484
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
031310-1 Issued in NY
Practice address
2605 Brewerton Rd
Mattydale, NY 13211-1147
Phone
(315) 455-9355
NPI assigned
Nov 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 031310-1 NY Primary

Addresses

Primary practice location

2605 Brewerton Rd
Mattydale, NY 13211-1147

Mailing address

2605 Brewerton Rd
Mattydale, NY 13211-1147
Phone (315) 455-9355

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
031310-1NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cltoperations, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1306316484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 BREWERTON RD",
            "city": "MATTYDALE",
            "state": "NY",
            "postal_code": "132111147",
            "telephone_number": "315-455-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 BREWERTON RD",
            "city": "MATTYDALE",
            "state": "NY",
            "postal_code": "132111147",
            "telephone_number": "315-455-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWSON",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "031310-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattydale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.