Samantha K Johnson, DC
Individual provider Active NPI Chiropractor · Ellsworth, WI
NPI 1124548201 · NPPES record last updated Apr 30, 2025
Key facts
- NPI
- 1124548201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5286-12 (WI)
- Practice address
- 187 East Main
Ellsworth, WI 54011 - Phone
- (715) 273-4115
- NPI assigned
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ellsworth Chiropractic and Wellness LLC
Practice addresses (Care Compare)
187 E Main St
Ellsworth, WI 54011-9188
Phone (715) 273-4115
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170821002385 | WI | Practitioner - Chiropractic | 8729350061 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5286-12 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ellsworth Chiropractic Inc | Chiropractor | Current |
Accepting new patients |
| Ellsworth Chiropractic & Wellness LLC | Chiropractor | Current |
Accepting new patients |
Locations
187 E Main St
Ellsworth, WI 54011
Phone (715) 273-4115
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5286-12 | WI | Yes |
Addresses
Primary practice location
187 East Main
Ellsworth, WI 54011
Mailing address
PO Box 668
Ellsworth, WI 54011-0668
Phone (715) 273-4115
Other providers in Ellsworth, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.