Individual provider Active NPI

Samantha Lynn Wiegand, M.D.

  • Maternal & Fetal Medicine Physician
  • Dayton, OH
National Provider Identifier
1578634275
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
35.085836 Issued in OH
Practice address
1 Wyoming St
Berry BLDG, Ground Floor
Dayton, OH 45409-2722
Phone
(937) 208-2516
Fax
(937) 208-6124
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 2012-00087 NC
Maternal & Fetal Medicine Physician 207VM0101X 35.085836 OH Primary

Addresses

Primary practice location

1 Wyoming St
Berry BLDG, Ground Floor
Dayton, OH 45409-2722

Mailing address

1 Wyoming St
Berry BLDG, Ground Floor
Dayton, OH 45409-2722
Phone (937) 208-2516

Other identifiers 1

IdentifierTypeStateIssuer
2839861MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20080715000832 OH Practitioner - Obstetrics/Gynecology 8426121054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wright State University Boonshoft School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722

100 Campus Loop Rd
Suite a
Middletown, OH 45005-5187
Phone (937) 439-0842

101 Looney Rd
Piqua, OH 45356-4153
Phone (937) 439-0842

2350 Miami Valley Dr
Centerville, OH 45459-4778

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

900 S Dixie Dr
Suite 20
Vandalia, OH 45377-2656
Phone (937) 387-0930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2012-00087NCMDMaternal & Fetal Medicine Physician
35.085836OHMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Aug 10, 2015 Accepting new patients
Premier Health Specialists Inc CurrentSince Aug 10, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients
Miami Valley Hospital Past Accepting new patients

Locations

2350 Miami Valley Dr
Ste 410
Centerville, OH 45459
Phone (937) 281-2370

2350 Miami Valley Dr
Ste 430E
Centerville, OH 45459
Phone (937) 439-0842

161 Wyoming St
Ste 100W
Dayton, OH 45409
Phone (937) 208-0500

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

1 Wyoming St
Bldg Grnd
Dayton, OH 45409

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

7117 Dutchland Pkwy
Liberty Township, OH 45044
Phone (513) 770-2797

100 Campus Loop Rd
Ste A
Middletown, OH 45005
Phone (513) 422-4522

101 Looney Rd
Ste B
Piqua, OH 45356

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

900 S Dixie Dr
Ste 20
Vandalia, OH 45377
Phone (937) 387-0930

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1578634275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "address_2": "BERRY BLDG, GROUND FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-2516",
            "fax_number": "937-208-6124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "address_2": "BERRY BLDG, GROUND FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-2516",
            "fax_number": "937-208-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NC",
            "license": "2012-00087",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "OH",
            "license": "35.085836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2839861",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.