Individual provider Active NPI

Samantha Correia Kline, DPT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1952769812
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61169792 Issued in WA
Practice address
2505 Racquet LN
Yakima, WA 98902-6114
Phone
(509) 453-7325
Fax
(509) 453-7330
NPI assigned
Feb 8, 2016
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13804 CO
Physical Therapist 225100000X PT61169792 WA Primary

Addresses

Primary practice location

2505 Racquet LN
Yakima, WA 98902-6114

Mailing address

2505 Racquet LN
Yakima, WA 98902-6114
Phone (509) 453-7325

Other names 1

  • Samantha Correia Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220421002261 WA Practitioner - Physical Therapist in Private Practice 0244627271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Performance Sports and SpineGroup PAC ID 5294753588, 4 clinicians

Practice addresses (Care Compare)

2505 Racquet LN
Yakima, WA 98902-6114
Phone (509) 453-7325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13804COMDPharmacist
PT61169792WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Sports and Spine Physical Therapist CurrentSince Jan 11, 2022 Accepting new patients
RPM Rehab, Inc Physical Therapist PastSince Jan 11, 2022 Accepting new patients

Locations

2505 Racquet Ln
Yakima, WA 98902
Phone (509) 453-7325

3904 Terrace Heights Dr
Ste A
Yakima, WA 98901
Phone (509) 453-7325

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, 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": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1952769812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 RACQUET LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026114",
            "telephone_number": "509-453-7325",
            "fax_number": "509-453-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 RACQUET LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026114",
            "telephone_number": "509-453-7325",
            "fax_number": "509-453-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "SAMANTHA",
        "middle_name": "CORREIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "13804",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61169792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "CORREIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.