Individual provider Active NPI

Samantha Gade, OTR

  • Occupational Therapist
  • Lincoln, NE
National Provider Identifier
1811397698
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1816 Issued in NE
Practice address
4640 Bair Ave
Suite 107
Lincoln, NE 68504-1183
Phone
(402) 742-7400
Fax
(402) 742-9592
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1816 NE Primary

Addresses

Primary practice location

4640 Bair Ave
Suite 107
Lincoln, NE 68504-1183

Mailing address

4640 Bair Ave
Suite 107
Lincoln, NE 68504-1183
Phone (402) 742-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222001590 NE Practitioner - Occupational Therapist in Private Practice 4981074580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1816NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Key Rehabilitation Inc CurrentSince Dec 1, 2022 Accepting new patients
Key Rehabilitation, Inc CurrentSince Dec 1, 2022 Accepting new patients
Leaps and Bounds Pediatric Therapy, P.C. Past Accepting new patients

Locations

1335 NW Broad St
Murfreesboro, TN 37129
Phone (615) 983-0240

Organizations & group practices 3

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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1811397698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 BAIR AVE",
            "address_2": "SUITE 107",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685041183",
            "telephone_number": "402-742-7400",
            "fax_number": "402-742-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 BAIR AVE",
            "address_2": "SUITE 107",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685041183",
            "telephone_number": "402-742-7400",
            "fax_number": "402-742-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADE",
        "first_name": "SAMANTHA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "1816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.