Active NPI
Samantha Sotherden, PT
- Physical Therapist
- Liverpool, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 043416
- Practice address
- 138 Old Liverpool Rd
Liverpool, NY 13088-6332 - Phone
- (516) 492-5708
- Fax
- (631) 467-0928
- NPI assigned
- Sep 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 006766-1 | NY | |
| Physical Therapist | 225100000X | 043416 | NY | Primary |
Addresses
Primary practice location
138 Old Liverpool Rd
Liverpool, NY 13088-6332
Mailing address
2222 Sullivan TRL
Easton, PA 18040-7958
Phone (516) 492-5708
Other practice location 1
159 W 1st St
Oswego, NY 13126-2045
Phone (315) 342-9575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
138 Old Liverpool Rd
Liverpool, NY 13088-6332
Phone (315) 460-6575
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043416 | NY | MD | Physical Therapist |
| 006766-1 | NY | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PRN Physical, Occupational and Speech Therapy Network, PLLC | Physical Therapist | Current | Accepting new patients |
| PRN Physical, Occupational and Speech Therapy Network, PLLC | Current | Accepting new patients |
Locations
138 Old Liverpool Rd
Liverpool, NY 13088
Phone (315) 460-6575
830 James St
Syracuse, NY 13203
Phone (315) 422-2173
2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058
Organizations & group practices 2
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.
-
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- NPI 1336185263
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- Durable Medical Equipment & Medical Supplies
- Troy, NY
- NPI 1568059665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1477887974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 SULLIVAN TRL",
"city": "EASTON",
"state": "PA",
"postal_code": "180407958",
"telephone_number": "516-492-5708",
"fax_number": "631-467-0928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 OLD LIVERPOOL RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130886332",
"telephone_number": "516-492-5708",
"fax_number": "631-467-0928"
}
],
"practiceLocations": [
{
"address_1": "159 W 1st St",
"address_purpose": "LOCATION",
"city": "Oswego",
"state": "NY",
"postal_code": "131262045",
"country_code": "US",
"telephone_number": "315-342-9575",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOTHERDEN",
"first_name": "SAMANTHA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-30",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "006766-1",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "043416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.