Samuel Robert Alexander, DC, LN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

N257 Issued in MN

Practice address

1700 S Hwy 36 Service Dr
#400
Roseville, MN 55113-2453

Phone

(507) 519-0552

NPI assigned

Dec 22, 2017

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MN

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Susan Borden Psych

  dba Center for Conscious Alchemy

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
  • NPI 1780313478
  Medicare reassignment
• Institute for Orthopedics & Chiropractic, PLLC

  • Chiropractor
  • Eden Prairie, MN
  • NPI 1306173950
  NPD (past)

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1134635485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10725 202ND ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447861",
            "telephone_number": "612-281-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S HWY 36 SERVICE DR",
            "address_2": "#400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132453",
            "telephone_number": "507-519-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "SAMUEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC, LN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-22",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6450",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MN",
            "license": "N257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmad Al-Samaraee, M.D.
• Jose A Alba Hernandez, PT, DPT
• Albert and Associates (Samuel Albert)
• Samuel Albert, PH.D.
• Ashlee Alberts, RD, LD, LMFT
• Siobhan Esther Alexander, M.D.
• Azhar T. Ali, MBBS
• Nimco Abdi Ali
• Nura Ali
• Rima Ali, MA, LPCC

• Nutritionist in Roseville, MN
• Providers in Roseville, MN by specialty
• Nutritionist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.