SAMANTHA ANN LIDDY (NPI# 1366753733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366753733 |
| Entity Type | Individual |
| Full Name | SAMANTHA ANN LIDDY |
| Credential | ATC |
| Practice Address |
100 A Lindsey Lane Kingsland GA 31548-0000 |
| Mailing Address |
Po Box 949 Rome GA 30162-0949 |
| Practice Telephone | 9127291333 |
| Practice Fax Number | 9127295259 |
| Mailing Telephone | 7068021991 |
| Mailing Fax Number | 7068021408 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AL2498 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT001475 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | LICENSES | AT001475 | 01 |
| FL | LICENSES | AL2498 | 01 |
| Street Address |
100 A LINDSEY LANE |
| City | KINGSLAND |
| State | GA |
| Zip Code | 31548-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407949134 | Richard J Mckibben | Physical Therapist | 100 A Lindsey Lane, Kingsland, GA 31548-0000 | 2006-10-02 |
| 1922334135 | William Edward Jones Jr. | Physical Therapy Assistant | 100 A Lindsey Lane, Kingsland, GA 31548 | 2009-10-22 |
| 1417197849 | Marsha Shackelford | Physical Therapist | 100 A Lindsey Lane, Kingsland, GA 31548 | 2009-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356984611 | Shelby Nichole Gambill | Nurse Practitioner | 103 Lake Palms Dr, Kingsland, GA 31548 | 2019-10-18 |
| 1629536339 | The Behavior Placellc | Behavior Technician | 103 Johansen Way, Kingsland, GA 31548 | 2019-03-12 |
| 1588020234 | Keywanna Nichole Price | Nurse Practitioner | 571 Henrietta St, Kingsland, GA 31548 | 2016-01-11 |
| 1083086243 | Sorinity Support Services, LLC | Nurse's Aide | 801 Hwy 40 East Ste A-139, Kingsland, GA 31548 | 2015-10-28 |
| 1740661594 | Briana Gray | Family Medicine | 1375 E King Ave Ste B, Kingsland, GA 31548 | 2015-06-17 |
| 1649670530 | Kimberly Grande | Physical Therapist | 100 B Lindsey Lane, Kingsland, GA 31548 | 2014-08-27 |
| 1598044307 | Margaret Peek Powell | Counselor | 100 Mariners Dr. Suite D, Kingsland, GA 31548 | 2011-08-10 |
| 1376850545 | Heavenly Devine Blessing | Home Delivered Meals | 105 North Lee Street, Kingsland, GA 31548 | 2010-09-08 |
| 1053649657 | Melissa Anne White | Nurse Practitioner | 701 Charles Gilman Jr Ave Ste B, Kingsland, GA 31548 | 2009-11-20 |
| 1629203690 | Genevieve Matherne | Occupational Therapist | 100b Lindsey Lane, Kingsland, GA 31548 | 2009-05-20 |
| Find all providers in zip 31548 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679500615 | Mary Elizabeth Branch | Specialist/Technologist | 1300 Middle School Rd, Kingsland, GA 31548-6208 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455959 | Mary Lee Richardson | Specialist/Technologist | 1591 Glenn Pl Sw, Mableton, GA 30126-1170 | 2020-10-25 |
| 1295332914 | Cayla Mckeon | Specialist/Technologist | 11 W 11th St Apt 17, Columbus, GA 31901-4239 | 2020-10-06 |
| 1205442472 | Si'ara Washington Farris | Specialist/Technologist | 564 Hillandale Park Dr, Lithonia, GA 30058-8833 | 2020-09-22 |
| 1033723150 | Grant Pheil | Specialist/Technologist | 3523 Old Penia Rd, Cordele, GA 31015-7714 | 2020-09-04 |
| 1376157933 | Jesus E Aviles | Specialist/Technologist | 755 Battery Ave Se, Atlanta, GA 30339-3017 | 2020-09-01 |
| 1588276943 | Jaden T Harris | Specialist/Technologist | 2205 Moncrieff St, Augusta, GA 30906-8905 | 2020-08-18 |
| 1891306437 | Tinasia Smalls | Specialist/Technologist | 100 Woodland Dr Apt 1416, Statesboro, GA 30458-6365 | 2020-08-16 |
| 1407467590 | Samantha Jean Libby | Specialist/Technologist | 2550 Akers Mill Rd Se Apt F14, Atlanta, GA 30339-3271 | 2020-08-12 |
| 1083224224 | John Christopher Hamil | Specialist/Technologist | 812 S Park St Ste 1, Carrollton, GA 30117-4412 | 2020-08-03 |
| 1780294926 | Andrew Alcantar | Specialist/Technologist | 7340 Fairmount Hwy Se, Calhoun, GA 30701-4023 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
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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.