Individual provider Active NPI

Samantha Grams, PT

  • Physical Therapist
  • St Charles, IL
National Provider Identifier
1821541749
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.022403 Issued in IL
Practice address
333 N Randall Rd
St Charles, IL 60174-1573
Phone
(312) 223-3800
NPI assigned
Jul 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.022403 IL Primary

Addresses

Primary practice location

333 N Randall Rd
St Charles, IL 60174-1573

Mailing address

4N970 E Mary Dr
St Charles, IL 60175-5533
Phone (708) 522-2336

Other practice location 1

400 E Hillcrest Dr
Ste 110
Dekalb, IL 60115-2480
Phone (815) 758-5508

Other practice location 2

725 6th St
Clarkston, WA 99403-2006
Phone (509) 758-8510

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
070.022403ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Knelsen Twin Rivers Physical Therapy Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Athletes Place, PLLC CurrentSince May 8, 2022 Accepting new patients

Locations

333 N Randall Rd
St Charles, IL 60174
Phone (312) 223-3800

725 6th St
Ste 101
Clarkston, WA 99403
Phone (509) 758-8510

725 6th St
Clarkston, WA 99403
Phone (509) 758-8510

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": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1821541749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4N970 E MARY DR",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601755533",
            "telephone_number": "708-522-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N RANDALL RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741573",
            "telephone_number": "312-223-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Hillcrest Dr",
            "address_2": "STE 110",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601152480",
            "country_code": "US",
            "telephone_number": "815-758-5508",
            "fax_number": "815-758-5537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 6th St",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "WA",
            "postal_code": "994032006",
            "country_code": "US",
            "telephone_number": "509-758-8510",
            "fax_number": "509-751-9149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAMS",
        "first_name": "SAMANTHA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.022403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.