Active NPI
Samantha Marie Martin, PT, DPT, BS
- Physical Therapist
- Brandon, FL
National Provider Identifier
1710310974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT28319
- Practice address
- 1056 E Brandon Blvd
Brandon, FL 33511-5509 - Phone
- (813) 413-5513
- NPI assigned
- Aug 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT28319 | FL | Primary |
Addresses
Primary practice location
1056 E Brandon Blvd
Brandon, FL 33511-5509
Mailing address
3903 Northdale Blvd
Ste 111W
Tampa, FL 33624-1853
Phone (813) 381-6778
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
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529366400000",
"number": "1710310974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3903 NORTHDALE BLVD",
"address_2": "STE 111W",
"city": "TAMPA",
"state": "FL",
"postal_code": "336241853",
"telephone_number": "813-381-6778",
"fax_number": "440-815-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1056 E BRANDON BLVD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115509",
"telephone_number": "813-413-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SAMANTHA",
"middle_name": "MARIE",
"credential": "PT, DPT, BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-12",
"last_updated": "2018-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT28319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.