Individual provider Active NPI

Joleen Kay Samson, D.C.

  • Chiropractor
  • Edina, MN
National Provider Identifier
1497845556
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC3699 Issued in MN
Practice address
5201 Eden Ave
Ste. 190
Edina, MN 55436-2316
Phone
(952) 920-9721
Fax
(952) 241-4355
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC3699 MN Primary

Addresses

Primary practice location

5201 Eden Ave
Ste. 190
Edina, MN 55436-2316

Mailing address

6708 Danbury Curv
Shakopee, MN 55379-8807
Phone (952) 403-7903

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC3699MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cerefin Chiropractic Clinic, Inc. Chiropractor PastSince Apr 21, 1995 Accepting new patients
Carter Yoder Chiropractic LLC Chiropractor PastSince Aug 18, 2019 Accepting new patients
Marty Clinic PA Chiropractor PastSince Jun 7, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497845556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 DANBURY CURV",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553798807",
            "telephone_number": "952-403-7903",
            "fax_number": "952-241-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 EDEN AVE",
            "address_2": "STE. 190",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362316",
            "telephone_number": "952-920-9721",
            "fax_number": "952-241-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "JOLEEN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "DC3699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.