Samantha Bambach, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

540 S Main St Ste C&D
Northville, MI 48167-1856

Phone

(248) 675-8160

Fax

(248) 675-8161

NPI assigned

Jan 6, 2021

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 Trenkle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1760070544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S MAIN ST STE C&D",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671856",
            "telephone_number": "248-675-8160",
            "fax_number": "248-675-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBACH",
        "first_name": "SAMANTHA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "TRENKLE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Cory Russell Baltazar, D.C.
• Tara A Baluck, M.S., T.L.L.P
• Brooke Ellen Bandy, LLMSW
• David Brandon Bandy, D.D.S.
• Sneh Bansil
• Sally S. Barbat, MA, LLP
• Diane J Bardsley, LPC

• Physical Therapist in Northville, MI
• Providers in Northville, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.

Verify at the official NPI Registry.