Samantha J. Wilson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070021287 Issued in IL

Practice address

1118 Hampshire St
Quincy, IL 62301-3027

Phone

(217) 222-6550

NPI assigned

Feb 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha J. Poppe Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Quincy Physicians & Surgeons Clinic, PLLC

  • Clinic/Center
  • Quincy, IL
  • NPI 1548234198
  Medicare reassignment NPD
• Quincy Physicians & Surgeons Clinic, PLLC

  • Rural Health Clinic/Center
  • Winchester, IL
  • NPI 1114105749
  NPD

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

{
    "created_epoch": "1423958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1609267491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 HAMPSHIRE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013027",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMANTHA",
        "middle_name": "J.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-15",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "POPPE",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lacey Williams, BS CADC
• Elizabeth Willing, M.A., CCC-SLP
• Chelsea Wilson, CNS
• Karen Wilson, CRNA
• Megan Wilson
• Steven Wilson, PT
• Janice Ivy Winn, MEC, LCPC
• Brittany Marie Winship, RD, LDN
• Theodora Alexandra Winter, MSED, LPC, NCC
• Wise Minds Therapy, PLLC

• Physical Therapist in Quincy, IL
• Providers in Quincy, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.