Individual provider Active NPI

Samantha Whitlatch, DNP, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fitchburg, WI
National Provider Identifier
1265323497
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
17082-33 Issued in WI
Practice address
2985 Triverton Pike Dr Ste 201
Fitchburg, WI 53711-5803
Phone
(608) 238-9991
Fax
(888) 608-0841
NPI assigned
Jul 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17082-33 WI Primary

Addresses

Primary practice location

2985 Triverton Pike Dr Ste 201
Fitchburg, WI 53711-5803

Mailing address

6499 Gina LN
Deforest, WI 53532-2419
Phone (608) 386-9018

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

LicenseStateTypeSpecialty
17082-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kayla Johnson LLC Psychiatric/Mental Health PastSince Jul 22, 2025 Accepting new patients
Psychology Clinic Inc. PastSince Jul 22, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1265323497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 GINA LN",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "535322419",
            "telephone_number": "608-386-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 TRIVERTON PIKE DR STE 201",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115803",
            "telephone_number": "608-238-9991",
            "fax_number": "888-608-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLATCH",
        "first_name": "SAMANTHA",
        "credential": "DNP, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "17082-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.