Samantha Clark, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202006809 Issued in VA

Practice address

9325 Midlothian Tpke Ste a
North Chesterfield, VA 23235-4943

Phone

(757) 490-3223

Fax

(757) 490-2936

NPI assigned

Oct 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Moore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rehabilitation Associates Inc

  • Pediatric Physical Therapist
  • Virginia Beach, VA
  • NPI 1205860764

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1962913871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 MIDLOTHIAN TPKE STE A",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354943",
            "telephone_number": "757-490-3223",
            "fax_number": "757-490-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 MIDLOTHIAN TPKE STE A",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354943",
            "telephone_number": "757-490-3223",
            "fax_number": "757-490-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMANTHA",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CJW Sports Medicine, LLC
• Claiborn & Associates Inc.
• Mica Lakey Claiborne, MSW
• Shameka Clark-Savage, LPC
• Lexus Clark
• Angela Brianne Clarke, NP
• Sheila D Clasbey, M.D.
• Rachel Ann Clay
• Harry Tyrell Clayton, LCSW
• Clearly at Hand,LLC

• Speech-Language Pathologist in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.