Active NPI
Samantha M Polson
- Athletic Trainer
- Terre Haute, IN
National Provider Identifier
1629566252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 567 N 5TH St
Terre Haute, IN 47809-1903 - Phone
- (708) 717-5017
- NPI assigned
- Apr 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
567 N 5TH St
Terre Haute, IN 47809-1903
Mailing address
731 Antioch Cir N
Terre Haute, IN 47803-9465
Phone (708) 717-5017
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1629566252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 ANTIOCH CIR N",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478039465",
"telephone_number": "708-717-5017",
"fax_number": "812-237-9612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "567 N 5TH ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478091903",
"telephone_number": "708-717-5017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSON",
"first_name": "SAMANTHA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-30",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.