Active NPI
Samantha Mae Oliphant
- Physical Therapy Assistant
- Ashland, WI
National Provider Identifier
1104368356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2554-19
- Practice address
- 1319 Beaser Ave
Ashland, WI 54806-3614 - Phone
- (715) 682-3468
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2554-19 | WI | Primary |
Addresses
Primary practice location
1319 Beaser Ave
Ashland, WI 54806-3614
Mailing address
61498 Beckman Rd
Marengo, WI 54855-3448
Phone (715) 413-1528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2554-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1104368356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61498 BECKMAN RD",
"city": "MARENGO",
"state": "WI",
"postal_code": "548553448",
"telephone_number": "715-413-1528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 BEASER AVE",
"city": "ASHLAND",
"state": "WI",
"postal_code": "548063614",
"telephone_number": "715-682-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIPHANT",
"first_name": "SAMANTHA",
"middle_name": "MAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2554-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashland, WI
- NSH Ashland LLC (Ashland Health Services)
- NSH-Court Manor LLC (Court Manor Health Services)
- Lynn Marie O'Connell, COTA
- Kim Marie Ogle, MD
- Valerie Marie Olby, COTA
- Tyler J Olson, DPT
- Orthopedic & Spine Therapy of Poplar, SC
- Orthopedic & Spine Therapy of Poplar, SC
- Michaela Rose Otterstatter
- John Charles Oujiri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.