Individual provider Active NPI

Justin Sampson, PT, DPT

  • Physical Therapist
  • Forest City, NC
National Provider Identifier
1891239042
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01707400 Issued in NJ
Practice address
189 W Main St
Forest City, NC 28043-3051
Phone
(828) 417-0090
NPI assigned
Dec 7, 2016
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP033593T NC
Physical Therapist 225100000X CP024954T CO
Physical Therapist 225100000X PT7013 ME
Physical Therapist 225100000X 40QA01707400 NJ Primary

Addresses

Primary practice location

189 W Main St
Forest City, NC 28043-3051

Mailing address

PO Box 412313
Boston, MA 02241-2313
Phone (914) 294-4050

Other practice location 1

1248 S Broadway
Denver, CO 80210-1504
Phone (720) 699-9095

Other practice location 2

8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195
Phone (303) 344-9090

Other practice location 3

1372 Route 9
Building #2
Toms River, NJ 08755-4038
Phone (732) 240-9296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, WA, NC, ME4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170201001466 NJ Practitioner - Physical Therapist in Private Practice 8426331232 Reassigns benefits to 1 organization
I20230727001614 WA Practitioner - Physical Therapist in Private Practice 8426331232 Reassigns benefits to 1 organization
I20241101002764 NC Practitioner - Physical Therapist in Private Practice 8426331232 Reassigns benefits to 1 organization
I20250211002855 ME Practitioner - Physical Therapist in Private Practice 8426331232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Physical Therapy CenterGroup PAC ID 8820168123, 117 clinicians

Practice addresses (Care Compare)

4022-4026 Route 9
Howell, NJ 07731-3315
Phone (732) 835-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP024954TCOMDPhysical Therapist
PT7013MEMDPhysical Therapist
CP033593TNCMDPhysical Therapist
40QA01707400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist Current Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Jan 14, 2025 Accepting new patients
Multicare Health System CurrentSince Jul 7, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Oct 14, 2024 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Atlantic Physical Therapy Center CurrentSince Dec 12, 2016 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Jan 14, 2025 Accepting new patients
Multicare Health System Physical Therapist CurrentSince Jul 7, 2023 Accepting new patients
Atlantic Physical Therapy Center Physical Therapist CurrentSince Dec 12, 2016 Accepting new patients

Locations

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

111 Ossipee Trl E
Ste 1151
Standish, ME 04084
Phone (207) 227-6203

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

189 W Main St
Forest City, NC 28043
Phone (828) 417-0090

1037 Route 70
Manchester, NJ 08759
Phone (732) 408-1800

1500 Meeting House Rd
Sea Girt, NJ 08750
Phone (732) 784-6545

1372 Route 9
Bldg 2
Toms River, NJ 08755
Phone (732) 240-9296

407 E Main St
Auburn, WA 98002
Phone (253) 545-0044

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1891239042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412313",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412313",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 W MAIN ST",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280433051",
            "telephone_number": "828-417-0090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1248 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802101504",
            "country_code": "US",
            "telephone_number": "720-699-9095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8101 E Lowry Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802307195",
            "country_code": "US",
            "telephone_number": "303-344-9090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1372 Route 9",
            "address_2": "Building #2",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087554038",
            "country_code": "US",
            "telephone_number": "732-240-9296",
            "fax_number": "732-240-9297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "JUSTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-07",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP033593T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP024954T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7013",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01707400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.