Individual provider Active NPI

Samantha Lynn Hodgman

  • Licensed Practical Nurse
  • Madison, WI
National Provider Identifier
1639655434
Registry record updated Jul 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
320727 Issued in WI
Practice address
5109 World Dairy Dr
Madison, WI 53718-3807
Phone
(608) 242-0220
NPI assigned
Jul 14, 2018
Last updated
Jul 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 320727 WI Primary

Addresses

Primary practice location

5109 World Dairy Dr
Madison, WI 53718-3807

Mailing address

1017 Jana LN
Madison, WI 53704-7865
Phone (608) 239-7215

Other names 1

  • Samantha Lynn Alarcon Former name

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
320727WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531526400000",
    "number": "1639655434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 JANA LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537047865",
            "telephone_number": "608-239-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 WORLD DAIRY DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183807",
            "telephone_number": "608-242-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGMAN",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-14",
        "last_updated": "2018-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "320727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ALARCON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.