Individual provider Active NPI

Samuel Andrew York

  • Physical Therapy Assistant
  • Augusta, ME
National Provider Identifier
1457189573
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PA6881 Issued in ME
Practice address
160 Riverside Dr
Augusta, ME 04330-4162
Phone
(207) 622-9467
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PA6881 ME Primary

Addresses

Primary practice location

160 Riverside Dr
Augusta, ME 04330-4162

Mailing address

160 Riverside Dr
Augusta, ME 04330-4162
Phone (207) 622-9467

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
PA6881MEMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1457189573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 RIVERSIDE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304162",
            "telephone_number": "207-622-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 RIVERSIDE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304162",
            "telephone_number": "207-622-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "SAMUEL",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA6881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.