MS. SAMANTHA ELIZABETH WILSON (NPI# 1295170959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295170959 |
| Entity Type | Individual |
| Full Name | MS. SAMANTHA ELIZABETH WILSON |
| Credential | MASSAGE THERAPIST |
| Practice Address |
2185 Northlake Pkwy Ste 100 Tucker GA 30084-4100 |
| Practice Telephone | 7704936360 |
| Practice Fax Number | 7704936350 |
| Mailing Telephone | 7704936360 |
| Mailing Fax Number | 7704936350 |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2013-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT004816 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | STATE LICENSE NUMBER | MT004816 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013492701 | Samantha May Wilson | Nurse Practitioner | 24100 Chagrin Blvd Ste 430, Beachwood, OH 44122-5567 | 2018-09-27 |
| 1568983252 | Samantha La Wilson | Counselor | 28115 Se 451st St, Enumclaw, WA 98022-9204 | 2017-07-03 |
| 1407393143 | Samantha Wilson | Specialist/Technologist | 1900 Broadmoore Drive, Lincoln, NE 68506 | 2017-01-19 |
| 1508465212 | Samantha S Wilson | Social Worker | 37 W 26th St, New York, NY 10010-1006 | 2020-10-22 |
| 1174145866 | Samantha Joan Wilson | Behavior Technician | 302 Railway Ave., Seward, AK 99664 | 2020-05-15 |
| 1740839216 | Samantha Stone Wilson | Speech-Language Pathologist | 6239 S East St Ste A, Indianapolis, IN 46227-2088 | 2019-09-08 |
| 1326607896 | Samantha Wilson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2019-06-10 |
| 1164081915 | Samantha Wilson | Nurse Practitioner | 1133 21st St Nw Ste 200, Washington, DC 20036-3324 | 2019-06-06 |
| 1992282024 | Samantha Castillo Wilson | Physician Assistant | 2350 Limestone Pkwy, Gainesville, GA 30501-2013 | 2018-07-21 |
| 1386143063 | Samantha Kuenzli Wilson | Physical Therapist | 401 Lambert Rd, Biscoe, NC 27209-9002 | 2018-02-07 |
| Street Address |
2185 NORTHLAKE PKWY STE 100 |
| City | TUCKER |
| State | GA |
| Zip Code | 30084-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295170868 | All Health Physical Therapy | Physical Therapist | 2185 Northlake Pkwy Ste 100, Tucker, GA 30084-4100 | 2013-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
| 1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
| 1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
| 1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
| 1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
| 1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
| 1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
| 1265802318 | Spine and Orthopedics of Atlanta, LLC | Clinic/Center | 1462 Montreal Rd Ste 218, Tucker, GA 30084 | 2015-10-01 |
| Find all providers in zip 30084 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356957989 | Sherryl Saunders | Massage Therapist | 1018 Oak Chase Dr Apt L, Tucker, GA 30084-8792 | 2020-09-18 |
| 1326661786 | Calvin A Johnson Jr. | Massage Therapist | 3983 Lavista Rd Ste 184, Tucker, GA 30084-5150 | 2020-05-20 |
| 1568092799 | Divine Wellness | Massage Therapist | 3469 Lawrenceville Hwy Ste 201, Tucker, GA 30084-5866 | 2020-01-15 |
| 1942771860 | Drexele Millian Jones | Massage Therapist | 2030 Tucker Industrial Rd Ste 123, Tucker, GA 30084-6253 | 2018-12-17 |
| 1548706633 | Heather Helen Hale | Massage Therapist | 4076 Morgan Rd, Tucker, GA 30084-3452 | 2017-01-12 |
| 1962709188 | Cindy Ellen Farrar | Massage Therapist | 5066 Lavista Rd, Tucker, GA 30084-3500 | 2011-02-24 |
| 1154638203 | Kathy A. Riederich | Massage Therapist | 501 Engle Dr, Tucker, GA 30084-2018 | 2010-09-10 |
| 1487977732 | S Domingo | Massage Therapist | 4112 Hughes Lea, Tucker, GA 30084-1101 | 2010-03-01 |
| 1720235328 | Claudia Maria Goicoechea | Massage Therapist | 2490 Oak Ave, Building A, Tucker, GA 30084-3517 | 2008-08-26 |
| 1932511979 | Elaine Ponder | Massage Therapist | 2323 Main St, Suite A2, Tucker, GA 30084-8522 | 2014-05-26 |
| Find all providers in TUCKER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.