NPI Code Detail JSON Logo

1912697897 NPI number — SAMANTHA JACLYN MARIE PAYNE OTD, OTR/L

NPI Number: 1912697897
Health Care Provider/Practitioner: SAMANTHA JACLYN MARIE PAYNE OTD, OTR/L

Information about “1912697897” NPI (SAMANTHA JACLYN MARIE PAYNE OTD, OTR/L) exists in 1912697897 in HTML format HTML  |  1912697897 in plain Text format TXT  |  1912697897 in PDF (Portable Document Format) PDF  |  1912697897 in an XML format XML  formats.

NPI Number : 1912697897 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912697897",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PAYNE",
    "FirstName": "SAMANTHA",
    "MiddleName": "JACLYN MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTD, OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2211 BRIGHTMOOR CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HENRICO",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23238-3205",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-239-5997",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2000 WILKES RIDGE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RICHMOND",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23233-7632",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "804-877-4000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/12/2023",
    "LastUpdateDate": "05/12/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "0119009582",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.