Individual provider Active NPI

Samantha Lynn Dipaolo, OTR/L, OTD

  • Occupational Therapist
  • Fayetteville, NC
National Provider Identifier
1639726425
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12674 Issued in NC
Practice address
1555 Cain Rd Ste 200
Fayetteville, NC 28303-3076
Phone
(910) 822-3490
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 12674 NC Primary

Addresses

Primary practice location

1555 Cain Rd Ste 200
Fayetteville, NC 28303-3076

Mailing address

4602 Cumberland Rd
Fayetteville, NC 28306-2412
Phone (910) 423-5622

Other names 1

  • Samantha Lynn Teneyck Former name

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
12674NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Playground, Inc PastSince Sep 1, 2019 Accepting new patients
Therapy Playground, Inc PastSince Sep 1, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1639726425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 CUMBERLAND RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062412",
            "telephone_number": "910-423-5622",
            "fax_number": "910-423-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 CAIN RD STE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033076",
            "telephone_number": "910-822-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPAOLO",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "OTR/L, OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "12674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "TENEYCK",
            "middle_name": "LYNN",
            "credential": "OTR/L, OTD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.