Individual provider Active NPI

Samantha Humpal, MS, RDN, LDN

  • Registered Dietitian
  • Twinsburg, OH
National Provider Identifier
1427884147
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
10127 Flagstone Dr
Twinsburg, OH 44087-4935
Phone
(440) 665-5585
NPI assigned
Sep 10, 2024
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

10127 Flagstone Dr
Twinsburg, OH 44087-4935

Mailing address

10127 Flagstone Dr
Twinsburg, OH 44087-4935
Phone (440) 665-5585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241111003776 TX Practitioner - Registered Dietitian Or Nutrition Professional 6002340221 Reassigns benefits to 1 organization
I20241119003355 OH Practitioner - Registered Dietitian Or Nutrition Professional 6002340221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Ilivewell Nutrition Therapy LLC Dietitian, Registered CurrentSince Sep 7, 2024 Accepting new patients
Nourish, Inc. Dietitian, Registered CurrentSince Sep 7, 2024 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Interoperability endpoints

  • Direct secure messaging: shumpal610716@ehrdirect.uhhospitals.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1427884147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10127 FLAGSTONE DR",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440874935",
            "telephone_number": "440-665-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10127 FLAGSTONE DR",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440874935",
            "telephone_number": "440-665-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPAL",
        "first_name": "SAMANTHA",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twinsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.