Active NPI
Samantha Koralesky, L.AC
- Acupuncturist
- Salem, WI
National Provider Identifier
1225410285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 799-55
- Practice address
- 7510 288TH Ave
2
Salem, WI 53168-9532 - Phone
- (262) 586-0199
- NPI assigned
- Jun 25, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 799-55 | WI | Primary |
Addresses
Primary practice location
7510 288TH Ave
2
Salem, WI 53168-9532
Mailing address
7510 288TH Ave
2
Salem, WI 53168-9532
Phone (262) 586-0199
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 799-55 | WI | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Grounds Center Corp | Acupuncturist | Current | Accepting new patients |
| Turning Leaf Acupuncture, LLC | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Acupuncturist
- Salem, WI
- NPI 1780088153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1225410285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7510 288TH AVE",
"address_2": "2",
"city": "SALEM",
"state": "WI",
"postal_code": "531689532",
"telephone_number": "262-586-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7510 288TH AVE",
"address_2": "2",
"city": "SALEM",
"state": "WI",
"postal_code": "531689532",
"telephone_number": "262-586-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORALESKY",
"first_name": "SAMANTHA",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-25",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WI",
"license": "799-55",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.