Individual provider Active NPI

Samantha Sarah Schmittinger

  • Licensed Practical Nurse
  • Oconomowoc, WI
National Provider Identifier
1396004826
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
TBA Issued in WI
Practice address
667 Summit Ave
Oconomowoc, WI 53066-3843
Phone
(262) 442-8377
NPI assigned
May 3, 2012
Last updated
May 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X TBA WI Primary

Addresses

Primary practice location

667 Summit Ave
Oconomowoc, WI 53066-3843

Mailing address

PO Box 245
Johnson Creek, WI 53038-0245
Phone (262) 442-8377

Other names 1

  • Samantha Sarah Sybrant Former name

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
TBAWIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1396004826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530380245",
            "telephone_number": "262-442-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663843",
            "telephone_number": "262-442-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITTINGER",
        "first_name": "SAMANTHA",
        "middle_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "TBA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SYBRANT",
            "middle_name": "SARAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.