Individual provider Active NPI

Samantha Thode-Thiaw, MS OTR/L

  • Occupational Therapist
  • Wilmington, NC
National Provider Identifier
1841068608
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
16452 Issued in NC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 343-0145
NPI assigned
Dec 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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 16452 NC Primary

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Other practice location 1

1806 S 15th St
Wilmington, NC 28401-6479
Phone (910) 343-0145

Other practice location 2

6 Doctors Cir Ste 1
Supply, NC 28462-6358
Phone (910) 790-9949

Other practice location 3

1886 NC Hwy S
Suite 133
Rocky Point, NC 28457
Phone (910) 343-0145

Other practice location 4

4036 Bus 17 East Bldg 600
Boliva, NC 28422
Phone (910) 343-0145

Other practice location 5

2700 N College Rd
Wilmington, NC 28405-8816
Phone (910) 343-0145

Other practice location 6

1414 Medical Center Dr
Wilmington, NC 28401-7505
Phone (910) 343-0145

Other practice location 7

110 Premiere Plz
Whiteville, NC 28472-2522
Phone (910) 343-0145

Other practice location 8

1307 Market St
Wilmington, NC 28401-4331
Phone (910) 343-0145

Other practice location 9

555 Halyburton Pkwy
Wilmington, NC 28412
Phone (910) 343-0145

Other practice location 10

309 Progress Dr
Burgaw, NC 28425-3280
Phone (910) 343-0145

Other practice location 11

7876 US Hwy 117 S # A
Rocky Point, NC 28457-8408
Phone (910) 343-0145

Other practice location 12

7910 US Hwy 117 S
Rocky Point, NC 28457-9431
Phone (910) 343-0145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201000861 NC Practitioner - Occupational Therapist in Private Practice 7113370545 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16452NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Horizons Center, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Coastal Horizons Center Inc CurrentSince Sep 1, 2025 Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
Raise the Bar Therapy Services Occupational Therapist CurrentSince Dec 12, 2023 Accepting new patients

Locations

309 Progress Dr
Burgaw, NC 28425
Phone (910) 259-0445

18676 US Highway 17
Hampstead, NC 28443
Phone (910) 270-4156

18676 US Highway 17
Ste 10
Hampstead, NC 28443
Phone (910) 821-1700

7876 US Hwy 117 S
#A
Rocky Point, NC 28457
Phone (910) 675-9200

7910 US Hwy 117 S
Rocky Point, NC 28457
Phone (910) 300-4320

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

1414 Medical Center Dr
Wilmington, NC 28401
Phone (910) 763-7363

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

Organizations & group practices 4

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": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1841068608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1806 S 15th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016479",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Doctors Cir Ste 1",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284626358",
            "country_code": "US",
            "telephone_number": "910-790-9949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1886 NC HWY S",
            "address_2": "Suite 133",
            "address_purpose": "LOCATION",
            "city": "Rocky Point",
            "state": "NC",
            "postal_code": "28457",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4036 Bus 17 East Bldg 600",
            "address_purpose": "LOCATION",
            "city": "Boliva",
            "state": "NC",
            "postal_code": "28422",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 N College Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284058816",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017505",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Premiere Plz",
            "address_purpose": "LOCATION",
            "city": "Whiteville",
            "state": "NC",
            "postal_code": "284722522",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1307 Market St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284014331",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Halyburton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "28412",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Progress Dr",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284253280",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7876 US Hwy 117 S # A",
            "address_purpose": "LOCATION",
            "city": "Rocky Point",
            "state": "NC",
            "postal_code": "284578408",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7910 US Hwy 117 S",
            "address_purpose": "LOCATION",
            "city": "Rocky Point",
            "state": "NC",
            "postal_code": "284579431",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THODE-THIAW",
        "first_name": "SAMANTHA",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.