Samantha Rose Hargreaves, MPH, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3776 Issued in MN

Practice address

3500 Vicksburg LN N # 113
Plymouth, MN 55447-1334

Phone

(612) 326-4049

NPI assigned

Jul 28, 2019

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 Rose Osterhaus Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindfully Well LLC

  • Registered Dietitian
  • Plymouth, MN
  • NPI 1063287241

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1033763123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 VICKSBURG LN N # 113",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 VICKSBURG LN N # 113",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471334",
            "telephone_number": "612-326-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGREAVES",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "credential": "MPH, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-28",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "OSTERHAUS",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.