Active NPI
Samantha Lucille Radel, ATC, LAT
- Athletic Trainer
- Waverly, IA
National Provider Identifier
1710125455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000641
- Practice address
- 100 Wartburg Blvd
Department of Athletics-Wartburg College
Waverly, IA 50677-2215 - Phone
- (319) 352-8725
- Fax
- (319) 352-8528
- NPI assigned
- Feb 3, 2009
- 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 | 000641 | IA | Primary |
Addresses
Primary practice location
100 Wartburg Blvd
Department of Athletics-Wartburg College
Waverly, IA 50677-2215
Mailing address
100 Wartburg Blvd
Department of Athletics-Wartburg College
Waverly, IA 50677-2215
Phone (319) 352-8725
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000641 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233619200000",
"number": "1710125455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WARTBURG BLVD",
"address_2": "DEPARTMENT OF ATHLETICS-WARTBURG COLLEGE",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772215",
"telephone_number": "319-352-8725",
"fax_number": "319-352-8528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WARTBURG BLVD",
"address_2": "DEPARTMENT OF ATHLETICS-WARTBURG COLLEGE",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772215",
"telephone_number": "319-352-8725",
"fax_number": "319-352-8528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADEL",
"first_name": "SAMANTHA",
"middle_name": "LUCILLE",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-03",
"last_updated": "2009-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "000641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.