Individual provider Active NPI

Samantha Jo Schuknecht, DPT

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1699032912
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018059 Issued in MI
Practice address
3435 Livernois Rd # 1a
Troy, MI 48083-5063
Phone
(248) 353-1234
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 000882 IA
Physical Therapist 225100000X 5501018059 MI Primary

Addresses

Primary practice location

3435 Livernois Rd # 1a
Troy, MI 48083-5063

Mailing address

29255 Northwestern Hwy Ste 300
Southfield, MI 48034-5742
Phone (248) 353-1234

Other practice location 1

29480 Woodward Ave
Royal Oak, MI 48073-0903
Phone (248) 541-9121

Other names 1

  • Samantha Jo Gabara 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
000882IAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Advanced Facial Plastic Surgery, PLLC CurrentSince Jul 14, 2024 Accepting new patients
Auto & Work Comp Rehab LLC PastSince Jul 24, 2022 Accepting new patients

Locations

3435 Livernois Rd
#1A
Troy, MI 48083

3435 Livernois Rd
Troy, MI 48083
Phone (248) 743-1234

Interoperability endpoints

  • Direct secure messaging: samantha.schuknecht.p4@direct.athleticoltd.nextgenshare.com

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699032912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY STE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345742",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 LIVERNOIS RD # 1A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835063",
            "telephone_number": "248-353-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29480 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480730903",
            "country_code": "US",
            "telephone_number": "248-541-9121",
            "fax_number": "248-541-8386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUKNECHT",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "000882",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GABARA",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.