Individual provider Active NPI

Samuel Joseph Vollbrecht, DPT

  • Physical Therapist
  • Millsboro, DE
National Provider Identifier
1881204923
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4292 Issued in NV
Practice address
28535 Dupont Blvd Unit 1
Millsboro, DE 19966-4799
Phone
(302) 297-0700
Fax
(302) 297-0701
NPI assigned
Aug 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4292 NV Primary

Addresses

Primary practice location

28535 Dupont Blvd Unit 1
Millsboro, DE 19966-4799

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

8402 Centennial Pkwy Ste 240
Las Vegas, NV 89149-4793
Phone (702) 294-7499

Other identifiers 1

IdentifierTypeStateIssuer
PT-2023-2277OtherNMLICENSE-PT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, NM, MO, ME4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20230509001859 AK Practitioner - Physical Therapist in Private Practice 1759708290 Reassigns benefits to 1 organization
I20231031002276 NM Practitioner - Physical Therapist in Private Practice 1759708290 Reassigns benefits to 1 organization
I20241007002210 MO Practitioner - Physical Therapist in Private Practice 1759708290 Reassigns benefits to 1 organization
I20260311004168 ME Practitioner - Physical Therapist in Private Practice 1759708290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

14802 Shamrock Way C
Serc Smithville
Smithville, MO 64089-8381
Phone (816) 873-1101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Health and Wellness Physical Therapy, Inc. Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Rumford Hospital CurrentSince Jan 28, 2026 Accepting new patients
Hometown Care, LLC Physical Therapist CurrentSince Nov 21, 2023 Accepting new patients
Rumford Hospital CurrentSince Jan 28, 2026 Accepting new patients
Serc Rehabilitation Partners, LLC Physical Therapist CurrentSince Sep 23, 2024 Accepting new patients
Serc Rebabilitation Partners, LLC Physical Therapist CurrentSince Sep 23, 2024 Accepting new patients
Sportherapy Southwest, PC Physical Therapist Past Accepting new patients

Locations

4079 Tongass Ave
Ste 102
Ketchikan, AK 99901
Phone (907) 225-7808

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051

109 W Franklin St
Clinton, MO 64735
Phone (660) 383-1280

3355 Main St
Kansas City, MO 64111
Phone (816) 399-0806

14802 Shamrock Way
Ste C
Smithville, MO 64089
Phone (816) 873-1100

834 Paseo del Pueblo Sur
Taos, NM 87571
Phone (575) 418-6787

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1881204923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28535 DUPONT BLVD UNIT 1",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199664799",
            "telephone_number": "302-297-0700",
            "fax_number": "302-297-0701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Centennial Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494793",
            "country_code": "US",
            "telephone_number": "702-294-7499",
            "fax_number": "702-294-7494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLLBRECHT",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-04",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE-PT",
            "identifier": "PT-2023-2277",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millsboro, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.