Christine S Samples Siegel, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 2583 Issued in MN

Practice address

5100 Eden Av
Ste 110
Edina, MN 55436

Phone

(952) 746-4780

Fax

(952) 746-4252

NPI assigned

Feb 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Christine Samples Bartz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1073585170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 EDEN AV",
            "address_2": "STE 110",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436",
            "telephone_number": "952-746-4780",
            "fax_number": "952-746-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 EDEN AV",
            "address_2": "STE 110",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436",
            "telephone_number": "952-746-4780",
            "fax_number": "952-746-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLES SIEGEL",
        "first_name": "CHRISTINE",
        "middle_name": "S",
        "credential": "LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 2583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "BARTZ",
            "middle_name": "SAMPLES",
            "credential": "LP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychologist in Edina, MN
• Providers in Edina, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; 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.