Active NPI
Samantha Rae Anderson, LPTA
- Physical Therapy Assistant
- Gatesville, NC
National Provider Identifier
1760077440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2300665501
- Practice address
- 11 Commerce Dr
Gatesville, NC 27938-9551 - Phone
- (252) 357-1379
- NPI assigned
- Mar 4, 2021
- 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 Therapy Assistant | 225200000X | 2300665501 | VA | Primary |
Addresses
Primary practice location
11 Commerce Dr
Gatesville, NC 27938-9551
Mailing address
11 Commerce Dr
Gatesville, NC 27938-9551
Phone (252) 357-1379
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | aflg.matrixcare.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2300665501 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1760077440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 COMMERCE DR",
"city": "GATESVILLE",
"state": "NC",
"postal_code": "279389551",
"telephone_number": "252-357-1379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 COMMERCE DR",
"city": "GATESVILLE",
"state": "NC",
"postal_code": "279389551",
"telephone_number": "252-357-1379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "SAMANTHA",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-04",
"last_updated": "2021-03-04",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2300665501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "aflg.matrixcare.com",
"affiliation": "N",
"endpointDescription": "documentation software",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "11 Commerce Dr",
"city": "Gatesville",
"state": "NC",
"country_code": "US",
"postal_code": "279389551",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gatesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.