Individual provider Active NPI

Samantha Barg

  • Physical Therapist
  • Rice Lake, WI
National Provider Identifier
1073170791
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14662-24 Issued in WI
Practice address
1035 N. Main Street
Rice Lake, WI 54868
Phone
(936) 203-3328
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14662-24 WI Primary

Addresses

Primary practice location

1035 N. Main Street
Rice Lake, WI 54868

Mailing address

1035 N. Main Street
Rice Lake, WI 54868
Phone (936) 203-3328

Other names 1

  • Samantha Sanders Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190729002453 WI Practitioner - Physical Therapist in Private Practice 9032445093 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Jul 8, 2019 Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 8, 2019 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jul 8, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 8, 2019 Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

1035 N Main St
Rice Lake, WI 54868
Phone (715) 234-4313

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1073170791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N. MAIN STREET",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "54868",
            "telephone_number": "936-203-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N. MAIN STREET",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "54868",
            "telephone_number": "936-203-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARG",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14662-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SANDERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.