Individual provider Active NPI

Alexa Samuels

  • Physical Therapy Assistant
  • Carrollton, TX
National Provider Identifier
1831830702
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A7372 Issued in NC
Practice address
1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904
Phone
(972) 237-0100
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A7372 NC Primary

Addresses

Primary practice location

1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904

Mailing address

6837 Tudor Dr
Plano, TX 75023-1054
Phone (434) 825-8959

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

LicenseStateTypeSpecialty
A7372NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CKC Holdings LLC CurrentSince Mar 24, 2024 Accepting new patients
CKC Holdings LLC CurrentSince Apr 10, 2022 Accepting new patients

Locations

1000 W Crosby Rd
Ste 136
Carrollton, TX 75006
Phone (972) 237-0100

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1831830702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6837 TUDOR DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750231054",
            "telephone_number": "434-825-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CROSBY RD STE 136",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066904",
            "telephone_number": "972-237-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "ALEXA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A7372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

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