Active NPI
Samantha Kaufman, DPT
- Physical Therapist
- Grafton, WI
National Provider Identifier
1588073928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12786-24
- Practice address
- 2020 Cheyenne CT
Grafton, WI 53024-9368 - Phone
- (262) 375-1075
- Fax
- (262) 375-4975
- NPI assigned
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12786-24 | WI | Primary |
Addresses
Primary practice location
2020 Cheyenne CT
Grafton, WI 53024-9368
Mailing address
2020 Cheyenne CT
Grafton, WI 53024-9368
Phone (920) 968-0814
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12786-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Sport & Spine, LLC | Physical Therapist | Past | Accepting new patients |
| Body Renovation Health Services, S.C. | 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.
-
- Physical Therapy Clinic/Center
- Grafton, WI
- NPI 1023210812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625443200000",
"number": "1588073928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 CHEYENNE CT",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249368",
"telephone_number": "920-968-0814",
"fax_number": "920-734-6159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 CHEYENNE CT",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249368",
"telephone_number": "262-375-1075",
"fax_number": "262-375-4975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "SAMANTHA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-11",
"last_updated": "2021-07-05",
"certification_date": "2021-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12786-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.