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NPI Code Detail

MEDICARE: SAMANTHA JEANINE LIPFORD OTR/L

MEDICARE: SAMANTHA JEANINE LIPFORD OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist15003NC
2225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1417411323
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA JEANINE LIPFORD OTR/L
Provider Business Mailing Address
First Line : 2082 BURNETT BLVD
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6940
Country : US
Telephone Number : 609-412-2413
Fax Number :
Provider Business Practice Location Address
First Line : 18676 US HIGHWAY 17
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-4049
Country : US
Telephone Number : 910-821-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2019
Last Update Date : 06/09/2026

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