Victoria Sam, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013480 Issued in GA

Practice address

3200 Shakerag HL Ste C
Peachtree City, GA 30269-6524

Phone

(770) 487-0760

Fax

(770) 487-0815

NPI assigned

Oct 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Lilburn, GA
  • NPI 1760568257
  Medicare reassignment NPD
• PR Physical Therapy

  • Physical Therapy Clinic/Center
  • Fayetteville, GA
  • NPI 1710749098
  NPD Authorized official
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1841662236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SHAKERAG HL STE C",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696524",
            "telephone_number": "770-487-0760",
            "fax_number": "770-487-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SHAKERAG HL STE C",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696524",
            "telephone_number": "770-487-0760",
            "fax_number": "770-487-0815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2079 Evergreen Dr",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301062017",
            "country_code": "US",
            "telephone_number": "404-680-2760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2079 Evergreen Dr",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301062017",
            "country_code": "US",
            "telephone_number": "404-680-2760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2079 Evergreen Dr",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301062017",
            "country_code": "US",
            "telephone_number": "404-680-2760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4125 Ironbound Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231882666",
            "country_code": "US",
            "telephone_number": "757-220-8383",
            "fax_number": "757-253-7833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "VICTORIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211591",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013480",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT871875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vsam@selectmedical.com",
            "affiliation": "Y",
            "endpointDescription": "Work E-mail",
            "affiliationName": "Physiotherapy Associates Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3200 Shakerag Hl Ste C",
            "city": "Peachtree City",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302696524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Diane Rusterucci, AGNP
• Sacred Soul Wellness & Counseling
• Adrian Chearell Sago, LPC
• Leslie Ann Salinski, OT
• Sandra Nicole Salter, NP
• Sams East Inc
• Kathy Ann Samuels, O.D.
• Sharon Sanders
• Zane T Scarborough, PH.D.
• Kelly Schleismann, PD.D.

• Physical Therapist in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.