Individual provider Active NPI

Samantha Chambers, D.C.

  • Chiropractor
  • Apple Valley, MN
National Provider Identifier
1255970471
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6694 Issued in MN
Practice address
14635 Pennock Ave Ste 200
Apple Valley, MN 55124-6587
Phone
(952) 693-1030
Fax
(952) 432-0701
NPI assigned
Jan 6, 2020
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6694 MN Primary

Addresses

Primary practice location

14635 Pennock Ave Ste 200
Apple Valley, MN 55124-6587

Mailing address

14631 Hampshire PL
Burnsville, MN 55306-4632
Phone (575) 760-9207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200411000242 MN Practitioner - Chiropractic 4486083540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

314 Main St E
Suite 1
New Prague, MN 56071-2448
Phone (952) 785-4121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsource Chiropractic of New Prague, PA Chiropractor CurrentSince Feb 12, 2022 Accepting new patients

Locations

314 Main St E
Ste 1
New Prague, MN 56071
Phone (952) 758-4121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1255970471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14631 HAMPSHIRE PL",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064632",
            "telephone_number": "575-760-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14635 PENNOCK AVE STE 200",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246587",
            "telephone_number": "952-693-1030",
            "fax_number": "952-432-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "SAMANTHA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.