Provider Demographics
NPI:1265009393
Name:SCHICK, SAMANTHA AMBER KELLER (PT, DPT, CPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:AMBER KELLER
Last Name:SCHICK
Suffix:
Gender:F
Credentials:PT, DPT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 KENNEDY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-2665
Mailing Address - Country:US
Mailing Address - Phone:513-618-7878
Mailing Address - Fax:513-618-7888
Practice Address - Street 1:5400 KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213
Practice Address - Country:US
Practice Address - Phone:513-618-7878
Practice Address - Fax:513-618-7888
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT2332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1770707671OtherANTHEM
OH1770707671OtherHUMANA
OH0480132Medicaid
OH1770707671OtherSHEAKLEY
OH1770707671OtherUNITED HEALTH CARE
OH1770707671OtherTRICARE
OH1770707671OtherUNITED MEDICAL RESOURCES
OH1770707671OtherSEDGWICK
OH1770707671OtherAMERICAN SPECIALTY HEALTH
OH1770707671Other3-HAB
OH1770707671OtherCAQH
OH1770707671OtherPROMEDICA