Nicholas Sample, CAA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

195-17 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Aug 29, 2014

Sex

Male

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

Enrolled in WI

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nsample553687@direct.emplifyhealth.org

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.

• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Gundersen Lutheran Medical Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • La Crosse, WI
  • NPI 1447478607
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1790646719

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • Onalaska, WI
  • NPI 1225372923

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1497090138

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc.

  • Air Ambulance
  • La Crosse, WI
  • NPI 1467468173

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • Winona, MN
  • NPI 1952959603

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1205236031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 Crown Pointe Estates Ct",
            "address_purpose": "LOCATION",
            "city": "Wildwood",
            "state": "MO",
            "postal_code": "630212012",
            "country_code": "US",
            "telephone_number": "314-971-5488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "NICHOLAS",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "195-17",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salucare Rehabilitative Agency S C
• Rasleen Kanwal Saluja, M.D.
• Hannah Marie Salwey
• Ashley Lee Sammann, LCSW
• Jerry W Sample, CADC
• Samuel James Sampson, MD
• Anasthasia L. Samson
• Abdallah Sanaani
• Anthony M Sanchez, PA
• Christie Sand, RDN

• Anesthesiologist Assistant in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Anesthesiologist Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.