Individual provider Active NPI

Samantha Vaughan

  • Physical Therapist
  • Southport, NC
National Provider Identifier
1316533078
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P23012 Issued in NC
Practice address
5013 Southport Crossing Way Ste 204
Southport, NC 28461-2206
Phone
(910) 604-9550
NPI assigned
Dec 17, 2020
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X P23012 NC Primary

Addresses

Primary practice location

5013 Southport Crossing Way Ste 204
Southport, NC 28461-2206

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

1661 Worcester Rd Ste 105
Framingham, MA 01701-5405
Phone (508) 626-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, PA, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201224000538 MA Practitioner - Physical Therapist in Private Practice 0345652913 Reassigns benefits to 1 organization
I20231106003414 PA Practitioner - Physical Therapist in Private Practice 0345652913 Reassigns benefits to 2 organizations
I20240513003304 NC Practitioner - Physical Therapist in Private Practice 0345652913 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Drexel University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy LLCGroup PAC ID 1951530849, 430 clinicians

Practice addresses (Care Compare)

555 E Lancaster Ave
Radnor, PA 19087-5158
Phone (484) 577-8950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Physical Therapy and Hand Specialist, LLC CurrentSince Jan 6, 2025 Accepting new patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Dec 28, 2020 Accepting new patients
Physical Therapy and Hand Specialists, LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Dec 28, 2020 Accepting new patients
Physical Therapy and Wellness Institute LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Drayer Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

790 Remington Blvd
Bolingbrook, IL 60440

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

1661 Worcester Rd
Ste 105
Framingham, MA 01701
Phone (508) 626-2600

207 E Meadow Rd
Ste 3
Eden, NC 27288
Phone (336) 627-3771

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

1901 NW Cary Pkwy
Ste 110
Morrisville, NC 27560
Phone (919) 678-1525

11201 Galleria Ave
Ste 105
Raleigh, NC 27614
Phone (919) 670-3350

1520 Sunday Dr
Ste 105
Raleigh, NC 27607
Phone (919) 420-1682

5013 Southport Crossing Way
Ste 204
Southport, NC 28461
Phone (910) 604-9550

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

1734 DeKalb Pike
Unit 4
Blue Bell, PA 19422
Phone (610) 707-8088

730 S Broad St
Lansdale, PA 19446
Phone (215) 855-9871

555 E Lancaster Ave
Radnor, PA 19087
Phone (267) 507-7572

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1316533078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5013 SOUTHPORT CROSSING WAY STE 204",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612206",
            "telephone_number": "910-604-9550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1661 Worcester Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017015405",
            "country_code": "US",
            "telephone_number": "508-626-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.