Samantha Fernholz, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006014 Issued in OH

Practice address

3535 W Sylvania Ave
Toledo, OH 43623-4479

Phone

(262) 664-1024

NPI assigned

May 8, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1497244040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 DUSTIR DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534021577",
            "telephone_number": "262-664-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234479",
            "telephone_number": "262-664-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNHOLZ",
        "first_name": "SAMANTHA",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "2255A2300X",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twila Renee Ferguson, R.N.
• Leslie Anne Fern
• Fernando Crotte MD - TLC LLC
• Shaneli Fernando, M.D.
• Susan L Ferner
• Gifford Ferrell
• Mark Ferrell, QMHS
• Karla Vanessa del Socorro Ferretti Cisneros Xavier, MD
• Tyler Ferretti
• John Anthony Ferris

• Athletic Trainer in Toledo, OH
• Providers in Toledo, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.