1013427368 NPI number — MS. SAMANTHA KATE VIOLA MS, AT, ATC

Table of content: SCHAWANNA LEVERETTE LPN (NPI 1194345637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013427368 NPI number — MS. SAMANTHA KATE VIOLA MS, AT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VIOLA
Provider First Name:
SAMANTHA
Provider Middle Name:
KATE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, AT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013427368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2871 SHIRLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48085-3972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-764-0770
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12901 15 MILE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STERLING HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48312-4202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-698-4973
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/01/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207PS0010X , with the licence number:  AT002468 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com