Samuel Ivan Bartlett, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

02005810A Issued in IN

Practice address

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Phone

(762) 408-2273

Fax

(762) 408-8103

NPI assigned

Jun 5, 2018

Last updated

Jun 15, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1467944462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-2273",
            "fax_number": "762-408-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-2273",
            "fax_number": "762-408-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "SAMUEL",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005810A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "02005810A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Barefield, RDH
• Robert Barker, DPM
• Robert David Jordan Barnes, DNP-FNP-BC
• Micheal David Barno
• Nicholas Barringer, RD
• Yolanda Y Bates, L.C.S.W.
• Crystal Bell, FNP-BC
• Joseph B. Belle, P.T.
• Pamela R Belle, PT , DPT
• Isis Bello Hernandez

• Sports Medicine (Family Medicine) Physician in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Sports Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.