Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samantha Bussard

Individual provider Physical Therapy Assistant · NPI 1235915075

Samantha Bussard is a Physical Therapy Assistant in Kingsport, Tennessee. Practices as a sole proprietor. Licensed in Tennessee and Virginia.

Licensed in
TN, VA
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone: (423) 765-9655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2306606242 (VA)
Physical Therapy Assistant Taxonomy 225200000X · Licence 8276 (TN)

Record details

NPI number1235915075
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 7, 2023
Last updated in NPPESSeptember 7, 2023
Certification dateSeptember 7, 2023
Mailing address1229 Church Hill Rd, Lebanon, VA 24266-3948

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