Individual provider Active NPI

Samantha Manuel

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1619761624
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4856 Issued in NV
Practice address
3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone
(702) 994-3773
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4856 NV Primary

Addresses

Primary practice location

3100 N Tenaya Way
Las Vegas, NV 89128-0436

Mailing address

6715 Marjoram St
Las Vegas, NV 89166-6083
Phone (702) 994-3773

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
4856NVMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1619761624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 MARJORAM ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666083",
            "telephone_number": "702-994-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280436",
            "telephone_number": "702-994-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.