Samuel Jon Hackett, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12290 Issued in SC

Practice address

123 E Medical LN
West Columbia, SC 29169-4813

Phone

(803) 791-2397

Fax

(803) 936-8184

NPI assigned

Jun 3, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Lexington County Health Services District, Inc.

  dba Lexington Medical Center Irmo

  • Urgent Care Clinic/Center
  • Columbia, SC
  • NPI 1396778056
  NPD (past)
• Saint Alphonsus Medical Center- Ontario Inc

  • General Acute Care Hospital
  • Ontario, OR
  • NPI 1013276831
  NPD (past)
• Sports & Ortho Rehab

  • Occupational Therapist
  • Ontario, OR
  • NPI 1013181437
  NPD (past)
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1366762122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E MEDICAL LN",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694813",
            "telephone_number": "803-791-2397",
            "fax_number": "803-936-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E MEDICAL LN",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694813",
            "telephone_number": "803-791-2397",
            "fax_number": "803-936-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S Bridgeway Pl",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836166099",
            "country_code": "US",
            "telephone_number": "208-385-3500",
            "fax_number": "208-385-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "SAMUEL",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6218",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ID",
            "license": "PT-2773",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shackett175790@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "123 E Medical Ln",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Guffey, PHARMD
• Paul Guffey
• Robyn Zalena Guinyard
• Brett C Gunter, M.D.
• David J Ha, MD
• Erin Cook Haggard, PA-C
• Sarah Haile, PT, DPT
• Aaron Bernard Haire, DPM
• Anisa Hakimji
• Elizabeth Halbing, LMSW

• Physical Therapist in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.