Angela Tise Sampson, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

3990 Issued in NC

Practice address

187 Vancouver CT
Kernersville, NC 27284-9256

Phone

(336) 996-4744

Fax

(336) 996-4745

NPI assigned

Nov 16, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Sampson Specialty Services, Inc.

  • Pediatric Occupational Therapist
  • Kernersville, NC
  • NPI 1881749471

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1467633628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 VANCOUVER CT",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849256",
            "telephone_number": "336-996-4744",
            "fax_number": "336-996-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 VANCOUVER CT",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849256",
            "telephone_number": "336-996-4744",
            "fax_number": "336-996-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "ANGELA",
        "middle_name": "TISE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "3990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1217F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D0591",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301309",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Sage
• Gysselle Salazar
• Salisbury Vamc
• Salisbury Vamc
• Sampson Specialty Services, Inc.
• Jadeen Sampson
• Susan D. Sander, N.P.
• Brittany Sanders, MSW, LCSW-A
• Katherine Anne Perkins Sanders, PA-C
• Rocco Delano Sandrella, DPT

• Pediatric Occupational Therapist in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Pediatric Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.