Healthcare Provider Details

I. General information

NPI: 1497366959
Provider Name (Legal Business Name): SAMANTHA D RIVERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GOOD HOPE RD SE APT 421
WASHINGTON DC
20020-5118
US

IV. Provider business mailing address

2401 CALVERT ST NW APT 615
WASHINGTON DC
20008-2671
US

V. Phone/Fax

Practice location:
  • Phone: 202-640-8497
  • Fax:
Mailing address:
  • Phone: 240-370-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: