Shalom Samuel, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5352-12 Issued in WI

Practice address

2810 Crossroads Dr Ste 4000
Madison, WI 53718-8014

Phone

(608) 616-4606

NPI assigned

Nov 2, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shalom Family Chiropractic, LLC

  • Health Service Clinic/Center
  • Sun Prairie, WI
  • NPI 1104704691
  NPD Authorized official
• Shalom Family Chiropractic, LLC

  • Chiropractor
  • Sun Prairie, WI
  • NPI 1366189565
  Authorized official Same address or phone
• Polly's Chiropractic, P.C.

  • Chiropractor
  • Bullhead City, AZ
  • NPI 1669677100
  NPD (past)

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1063841807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 PROVIDENCE CMN",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535904586",
            "telephone_number": "608-886-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 CROSSROADS DR STE 4000",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537188014",
            "telephone_number": "608-616-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SHALOM",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8352",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5352-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam James Samuel, PA-C
• Allison Samuel, PHARMD
• Ashlin Samuel
• Chijioke Akam Samuel
• Kassandra Marie Sakura Samuel
• Gregory M Samuels, DDS
• Amy Lynn Samuelson, DPT
• Erica Samuelson, COTA/L
• Eden Data Sana
• Marquis Luis Sanabrais, PT, DPT

• Chiropractor in Madison, WI
• Providers in Madison, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.