Samantha Eileen Kolb
Individual provider Active NPI Family Nurse Practitioner · Saint Joseph, MN
NPI 1003697947 · NPPES record last updated Dec 12, 2023
Key facts
- NPI
- 1003697947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10852 (MN)
- Practice address
- 1360 Elm St E
Saint Joseph, MN 56374-4694 - Phone
- (320) 363-7765
- NPI assigned
- Oct 6, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centracare Clinic
Practice addresses (Care Compare)
1360 Elm St E
Centracare Clinic St Joseph
St Joseph, MN 56374-4694
Phone (320) 363-7765
Hospital & facility affiliations
- Centracare Hospice
- Centracare - St. Cloud Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231106002519 | MN | Practitioner - Nurse Practitioner | 9537516083 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients |
Locations
715 1st St N
Cold Spring, MN 56320
Phone (320) 685-3693
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
1360 Elm St E
Saint Joseph, MN 56374
Phone (320) 363-7765
Interoperability endpoints
- stheisen763151@direct.centracare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10852 | MN | Yes |
Addresses
Primary practice location
1360 Elm St E
Saint Joseph, MN 56374-4694
Mailing address
7548 Landau Ave NE
Otsego, MN 55301-4526
Phone (952) 356-4629
Other providers in Saint Joseph, MN
- Carol L Holton
- Rose Anne Janssen
- Jessica G Counseling
- Katie Kremer Johnson
- K Welz LLC
- Brian S Koltes
- Angela Marie Larcom
- Jennie Joy Lewis
- Alexa Jo Loxtercamp
- Patricia Ann Martini
All providers in Saint Joseph, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.