Individual provider Active NPI

Samantha Roedel, PT, DPT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1801386305
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13611 Issued in WI
Practice address
4351 Avent Ferry Rd Apt 2
Raleigh, NC 27606-4780
Phone
(952) 201-2728
NPI assigned
May 10, 2018
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17834 NC
Physical Therapist 225100000X 10345 MN
Physical Therapist 225100000X 13611 WI Primary

Addresses

Primary practice location

4351 Avent Ferry Rd Apt 2
Raleigh, NC 27606-4780

Mailing address

4351 Avent Ferry Rd Apt 2
Raleigh, NC 27606-4780

Other practice location 1

1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 236-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250916000509 WI Practitioner - Physical Therapist in Private Practice 4587168430 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13611WIMDPhysical Therapist
17834NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jul 28, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Jul 28, 2025 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 28, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jul 28, 2025 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Jul 28, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jul 28, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Jul 28, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 28, 2025 Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1801386305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 AVENT FERRY RD APT 2",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276064780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 AVENT FERRY RD APT 2",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276064780",
            "telephone_number": "952-201-2728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 W Stout St",
            "address_purpose": "LOCATION",
            "city": "Rice Lake",
            "state": "WI",
            "postal_code": "548685000",
            "country_code": "US",
            "telephone_number": "715-236-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEDEL",
        "first_name": "SAMANTHA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "17834",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10345",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.