Individual provider Active NPI

Samantha Myers, MS, LAT, ATC

  • Athletic Trainer
  • Austin, TX
National Provider Identifier
1710419536
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
5549 Issued in FL
Practice address
1300 Martin Luther King Jr Dr
Austin, TX 78722-2517
Phone
(925) 726-7073
Fax
(512) 232-3988
NPI assigned
Mar 30, 2017
Last updated
Jan 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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 AT9477 TX
Athletic Trainer 2255A2300X 5549 FL Primary

Addresses

Primary practice location

1300 Martin Luther King Jr Dr
Austin, TX 78722-2517

Mailing address

PO Box 303901
Austin, TX 78703-0068
Phone (925) 726-7073

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5549FLMDOptometrist
AT9477TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1710419536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303901",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787030068",
            "telephone_number": "925-726-7073",
            "fax_number": "512-232-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MARTIN LUTHER KING JR DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787222517",
            "telephone_number": "925-726-7073",
            "fax_number": "512-232-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SAMANTHA",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT9477",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "5549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.