Individual provider Active NPI

Samantha Anne Myers, DPT

  • Physical Therapist
  • Mooresville, NC
National Provider Identifier
1730554635
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21318 Issued in NC
Practice address
114 Welton Way
Suite B
Mooresville, NC 28117-9251
Phone
(704) 660-6551
Fax
(704) 660-9894
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X P21318 NC Primary

Addresses

Primary practice location

114 Welton Way
Suite B
Mooresville, NC 28117-9251

Mailing address

114 Welton Way
Suite B
Mooresville, NC 28117-9251
Phone (704) 660-6551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220928003700 NC Practitioner - Physical Therapist in Private Practice 6204254717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taylor Rehab IncGroup PAC ID 4587558846, 10 clinicians

Practice addresses (Care Compare)

114 Welton Way
Suite B
Mooresville, NC 28117-9251
Phone (704) 660-6551

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
86.14
Improvement activities
40
Cost
74.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P21318NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Rehab Inc Physical Therapist CurrentSince Jul 5, 2022 Accepting new patients
Complete Rehabilitation and Sports Physical Therapy, PC Physical Therapist PastSince Jul 5, 2022 Accepting new patients

Locations

114 Welton Way
Ste B
Mooresville, NC 28117
Phone (704) 660-6551

167 Gateway Blvd
Mooresville, NC 28117
Phone (704) 658-1095

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1730554635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WELTON WAY",
            "address_2": "SUITE B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179251",
            "telephone_number": "704-660-6551",
            "fax_number": "704-660-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WELTON WAY",
            "address_2": "SUITE B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179251",
            "telephone_number": "704-660-6551",
            "fax_number": "704-660-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.