Active NPI
Samantha Samuels
- Registered Dietitian
- Wayland, MI
National Provider Identifier
1154145175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 803 Wild Flower CT
Wayland, MI 49348-1480 - Phone
- (616) 299-8177
- NPI assigned
- Nov 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | MI | ||
| Registered Dietitian | 133V00000X | TX | Primary |
Addresses
Primary practice location
803 Wild Flower CT
Wayland, MI 49348-1480
Mailing address
803 Wild Flower CT
Wayland, MI 49348-1480
Phone (616) 401-9020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1154145175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 WILD FLOWER CT",
"city": "WAYLAND",
"state": "MI",
"postal_code": "493481480",
"telephone_number": "616-401-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 WILD FLOWER CT",
"city": "WAYLAND",
"state": "MI",
"postal_code": "493481480",
"telephone_number": "616-299-8177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-15",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.