Samantha Rose Waelde, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017934 Issued in MI

Practice address

26025 Lahser Rd
Southfield, MI 48033-2606

Phone

(248) 663-1910

Fax

(248) 849-0190

NPI assigned

Sep 7, 2016

Last updated

Mar 18, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Michigan Orthopaedic Surgeons, PLLC

  • Orthopaedic Surgery Physician
  • Southfield, MI
  • NPI 1306394309

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1386191492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26025 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332606",
            "telephone_number": "248-663-1910",
            "fax_number": "248-849-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAELDE",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Vue, PTA
• Wallace Waalkes
• Christopher Andrew Wade
• Jennifer Wade
• Patricia Wade
• Gunnar Waggener
• Alyssa Wagner
• Caterina Wagner
• Dejanae Tianna Wagner
• Karl Gordon Wagner Jr., PA-C

• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.