Individual provider Active NPI

Samantha Scheel, OT

  • Occupational Therapist
  • Kokomo, IN
National Provider Identifier
1407417074
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31006900A Issued in IN
Practice address
1220 Laguna St
Kokomo, IN 46902-2330
Phone
(765) 454-5340
Fax
(765) 454-5347
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31006900A IN Primary

Addresses

Primary practice location

1220 Laguna St
Kokomo, IN 46902-2330

Mailing address

1220 Laguna St
Kokomo, IN 46902-2330
Phone (765) 454-5340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716001028 MN Practitioner - Occupational Therapist in Private Practice 5496179061 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31006900AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Center for Vital Living Occupational Therapist CurrentSince Sep 22, 2025 Accepting new patients

Locations

309 W 1st St
Duluth, MN 55802
Phone (218) 624-4828

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1407417074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 LAGUNA ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022330",
            "telephone_number": "765-454-5340",
            "fax_number": "765-454-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LAGUNA ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022330",
            "telephone_number": "765-454-5340",
            "fax_number": "765-454-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEEL",
        "first_name": "SAMANTHA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31006900A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.