Active NPI
Raynetta Samuels, PT
- Physical Therapist
- Washington, DC
National Provider Identifier
1457581746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 871033
- Practice address
- 3301 New Mexico Ave NW
Suite 318
Washington, DC 20016-3622 - Phone
- (800) 793-5464
- NPI assigned
- Jul 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 871033 | DC | Primary |
Addresses
Primary practice location
3301 New Mexico Ave NW
Suite 318
Washington, DC 20016-3622
Mailing address
P.O. Box 866308
Plano, TX 75086-6308
Phone (800) 793-5464
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 871033 | DC | MD | Physical Therapist |
| 003388 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249862400000",
"number": "1457581746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 866308",
"city": "PLANO",
"state": "TX",
"postal_code": "750866308",
"telephone_number": "800-793-5464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 NEW MEXICO AVE NW",
"address_2": "SUITE 318",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200163622",
"telephone_number": "800-793-5464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "RAYNETTA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-21",
"last_updated": "2009-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "871033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.