Individual provider Active NPI

Samantha Suzann Pagel, REGISTERED NURSE

  • Acute Care Clinical Nurse Specialist
  • Saint Paul, MN
National Provider Identifier
1588313563
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
2497570 Issued in MN
Practice address
1677 Sherburne Ave
Saint Paul, MN 55104-2254
Phone
(612) 759-0237
NPI assigned
Mar 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 2497570 MN Primary

Addresses

Primary practice location

1677 Sherburne Ave
Saint Paul, MN 55104-2254

Mailing address

1300 Hidden Lakes Pkwy
Golden Valley, MN 55422-4286
Phone (763) 588-2750

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
2497570MNMDAcute Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1588313563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HIDDEN LAKES PKWY",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224286",
            "telephone_number": "763-588-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 SHERBURNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042254",
            "telephone_number": "612-759-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGEL",
        "first_name": "SAMANTHA",
        "middle_name": "SUZANN",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "MN",
            "license": "2497570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.