Samantha Jean Stimac, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14689-24 Issued in WI

Practice address

112 E 5TH Ave
Antigo, WI 54409-2710

Phone

(715) 623-9449

NPI assigned

Jun 21, 2019

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1285295105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 MILTON ST",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092112",
            "telephone_number": "715-350-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIMAC",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14689-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "samantha.stimac@aspirus.org",
            "affiliation": "Y",
            "endpointDescription": "Work email",
            "affiliationName": "Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "112 E 5th Ave",
            "city": "Antigo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544092710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Antigo, WI
• Providers in Antigo, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.