Samantha Smith, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3960 Issued in ME

Practice address

163 Northport Ave
Belfast, ME 04915-6192

Phone

(207) 505-4584

NPI assigned

Nov 4, 2015

Last updated

Mar 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Ellis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1720451412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 NORTHPORT AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156192",
            "telephone_number": "207-505-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 NORTHPORT AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156192",
            "telephone_number": "207-505-4584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 Bath Rd",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112637",
            "country_code": "US",
            "telephone_number": "207-406-7950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMANTHA",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT476",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ELLIS",
            "credential": "PT, DPT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marisa Small
• Frederick Gregory Smith, PT
• Julie Anne Smith, LADC
• Megan Smith
• Pamela R Smith
• Terrance E Smith, M.D.
• Alicia Snow, NP-C
• Kimberly Hewitt Spectre, NP
• Margaret Spencer-Smith
• Jennifer Spofford, LMSW-CC

• Physical Therapist in Belfast, ME
• Providers in Belfast, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.