Individual provider Active NPI

Samantha Lee Schwieger

  • Physical Therapy Assistant
  • Pine City, MN
National Provider Identifier
1790298891
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A2268 Issued in MN
Practice address
129 6TH Ave SE
Pine City, MN 55063-1913
Phone
(320) 629-2542
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2688-19 WI
Physical Therapy Assistant 225200000X A2268 MN Primary

Addresses

Primary practice location

129 6TH Ave SE
Pine City, MN 55063-1913

Mailing address

12328 W Lara Rd
Grantsburg, WI 54840

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A2268MNMDPhysical Therapy Assistant
2688-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1790298891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12328 W LARA RD",
            "city": "GRANTSBURG",
            "state": "WI",
            "postal_code": "54840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 6TH AVE SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631913",
            "telephone_number": "320-629-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWIEGER",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2688-19",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.