Individual provider Active NPI

Samantha Leigh Ellig, PT

  • Physical Therapist
  • Chula Vista, CA
National Provider Identifier
1295021384
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39327 Issued in CA
Practice address
234 3Rd Ave
Suite B
Chula Vista, CA 91910-2754
Phone
(619) 589-2606
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60224802 WA
Physical Therapist 225100000X 39327 CA Primary

Addresses

Primary practice location

234 3Rd Ave
Suite B
Chula Vista, CA 91910-2754

Mailing address

5905 Severin Dr
La Mesa, CA 91942-3806
Phone (619) 589-2606

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60224802WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harada Physical Therapy & Rehab Services Inc., P.S. Physical Therapist PastSince Jul 8, 2019 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1295021384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 SEVERIN DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423806",
            "telephone_number": "619-589-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 3RD AVE",
            "address_2": "SUITE B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102754",
            "telephone_number": "619-589-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIG",
        "first_name": "SAMANTHA",
        "middle_name": "LEIGH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60224802",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.