Individual provider Active NPI

Samantha Marie Warren, DPT

  • Orthopedic Physical Therapist
  • Jbphh, HI
National Provider Identifier
1790938371
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
24385 Issued in FL
Practice address
755 Scott Cir
Jbphh, HI 96853-5399
Phone
(888) 683-2778
NPI assigned
Oct 28, 2008
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14091 NC
Orthopedic Physical Therapist 2251X0800X 24385 FL Primary
Physical Therapist 225100000X 24385 FL

Addresses

Primary practice location

755 Scott Cir
Jbphh, HI 96853-5399

Mailing address

755 Scott Cir
Jbphh, HI 96853-5399
Phone (888) 683-2778

Other practice location 1

2550 Ravenhill Dr
Suite 103
Fayetteville, NC 28303-9627
Phone (910) 484-8492

Other practice location 2

90 Hope Dr Bldg 6000
Mountain Home AFB, ID 83648
Phone (208) 828-2175

Other practice location 3

88th Medical Group
4881 Sugar Maple Drive
Wpafb, OH 45433
Phone (937) 257-9035

Other names 1

  • Dr. Samantha Marie Berger Former name

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

State licenses

LicenseStateTypeSpecialty
24385FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Therapy of North Carolina Inc Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1790938371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "888-683-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "888-683-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Ravenhill Dr",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283039627",
            "country_code": "US",
            "telephone_number": "910-484-8492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Hope Dr Bldg 6000",
            "address_purpose": "LOCATION",
            "city": "Mountain Home AFB",
            "state": "ID",
            "postal_code": "83648",
            "country_code": "US",
            "telephone_number": "208-828-2175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "88th Medical Group",
            "address_2": "4881 Sugar Maple Drive",
            "address_purpose": "LOCATION",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "45433",
            "country_code": "US",
            "telephone_number": "937-257-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "14091",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "24385",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "24385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BERGER",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jbphh, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.