Active NPI
Samantha Doty, PA-C
- Physician Assistant
- Mount Pleasant, WI
National Provider Identifier
1639527989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3838-23
- Practice address
- 3801 Spring St
Mount Pleasant, WI 53405-1667 - Phone
- (262) 687-4201
- NPI assigned
- May 27, 2016
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3838-23 | WI | Primary |
Addresses
Primary practice location
3801 Spring St
Mount Pleasant, WI 53405-1667
Mailing address
3801 Spring St
Racine, WI 53405
Phone (262) 687-4201
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3838-23 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1639527989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 SPRING ST",
"city": "RACINE",
"state": "WI",
"postal_code": "53405",
"telephone_number": "262-687-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 SPRING ST",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534051667",
"telephone_number": "262-687-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTY",
"first_name": "SAMANTHA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-27",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3838-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.