Samuel Richard James Deboer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

092492 Issued in IA

Practice address

312 9TH St SW
Waverly, IA 50677-2929

Phone

(319) 352-5644

NPI assigned

Aug 2, 2018

Last updated

Aug 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Taylor Physical Therapy Associates LLCGroup PAC ID 1951405174, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Taylor Physical Therapy Associates LLC

  • Physical Therapist
  • Sumner, IA
  • NPI 1861591745
  Medicare reassignment Care Compare group
• Taylor Physical Therapy Associates, LLC

  • Physical Therapist
  • Parkersburg, IA
  • NPI 1194052076
  NPD

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1295213007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 1ST AVE NE",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772716",
            "telephone_number": "319-939-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772929",
            "telephone_number": "319-352-5644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1306 Highway 57 Ste B",
            "address_purpose": "LOCATION",
            "city": "Parkersburg",
            "state": "IA",
            "postal_code": "506651075",
            "country_code": "US",
            "telephone_number": "319-346-9783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "SAMUEL",
        "middle_name": "RICHARD JAMES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "092492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Marie Darling
• Daniel J Darnold, MD
• Danielle Faith Davis, SLP
• Jan Paula Davis, ARNP
• Dean H. Sheller D.D.S., PC
• Kaygen Kay Deitrick, LMSW
• Denise Kay Dermody, OTR
• John Scott Dickinson, LMHC
• Haley Alane Dietrick, OTR/L
• Amanda S Dixon, OTR

• Physical Therapist in Waverly, IA
• Providers in Waverly, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.