Individual provider Active NPI

Breanna Samoleski, DC

  • Chiropractor
  • Hudson, WI
National Provider Identifier
1366031569
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5609-12 Issued in WI
Practice address
832 Carmichael Rd
Hudson, WI 54016-7759
Phone
(715) 381-1800
Fax
(715) 381-5234
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5609-12 WI Primary

Addresses

Primary practice location

832 Carmichael Rd
Hudson, WI 54016-7759

Mailing address

832 Carmichael Rd
Hudson, WI 54016-7759
Phone (715) 381-1800

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
5609-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Chiropractic, LLC Chiropractor CurrentSince Jan 17, 2021 Accepting new patients

Locations

832 Carmichael Rd
Hudson, WI 54016
Phone (715) 303-3200

Organizations & group practices 1

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1366031569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167759",
            "telephone_number": "715-381-1800",
            "fax_number": "715-381-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167759",
            "telephone_number": "715-381-1800",
            "fax_number": "715-381-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOLESKI",
        "first_name": "BREANNA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5609-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.

Verify at the official NPI Registry.