Shuba Samuel, FNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4599 Issued in WI

Practice address

10 Tri Park Way # Wi
Appleton, WI 54914-1658

Phone

(920) 831-0070

NPI assigned

Oct 21, 2011

Sex

Female

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, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oak Medical SCGroup PAC ID 0042595175, 118 clinicians

Horizon Healthcare, IncGroup PAC ID 0749182160, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Oak Medical SC

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1669910345

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Horizon Healthcare, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1225052830
  Medicare reassignment Care Compare group
• Maple Medical SC

  • Physical Medicine & Rehabilitation Physician
  • Waukesha, WI
  • NPI 1487152104
  Medicare reassignment NPD
• Schoolcraft Memorial Hospital

  • Critical Access Hospital
  • Manistique, MI
  • NPI 1700805157
  Medicare reassignment NPD
• Horizon Healthcare, Inc.

  • General Practice Physician
  • Kenosha, WI
  • NPI 1720492309

  Family

  NPD
• Milwaukee Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Appleton, WI
  • NPI 1669643912
  NPD (past)

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1326324385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 RANGE ST",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY # WI",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 S Howell Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532075908",
            "country_code": "US",
            "telephone_number": "414-376-5577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SHUBA",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "4599",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4599",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Francis Salm, M.D.
• Nicole A Salm, OTR, CHT
• Sam'S Club Optical
• Sams East Inc
• Samton Health LLC
• Alison Maria Sanderfoot, RDH
• Joshua Sanders, MS, LAT
• Brad Sandleback, MD
• Kenneth Sandler, DDS
• Felipe Sandoval, RN

• Psychiatric/Mental Health Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.