Samuel Mario Barros

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1603 Georgia Highway 20 NE Ste 201
Conyers, GA 30012-3946

Phone

(770) 929-8411

NPI assigned

Aug 29, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1548045404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4846 NW 107TH PSGE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784353",
            "telephone_number": "617-501-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 GEORGIA HIGHWAY 20 NE STE 201",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123946",
            "telephone_number": "770-929-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARROS",
        "first_name": "SAMUEL",
        "middle_name": "MARIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amit Singh Bajwa, DDS
• R. Wayne Baker, OD
• Samantha Banks, MSN, FNP-C
• Stephanie Baptiste, PHARMD
• Shamora Barnard
• Ashlyn Faith Bartello, PA-C
• Charles Bartholomew, PH.D.
• Monika Bartoli
• Barbara W Barylska, MD
• Enas Basha, NP

• Physical Therapist in Conyers, GA
• Providers in Conyers, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.