Individual provider Active NPI

Samantha Walker, RDN

  • Registered Dietitian
  • Milwaukee, WI
National Provider Identifier
1811771769
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
5186-29 Issued in WI
Practice address
945 N 12TH St Ste 4602
Milwaukee, WI 53233-1305
Phone
(414) 219-3008
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 5186-29 WI Primary

Addresses

Primary practice location

945 N 12TH St Ste 4602
Milwaukee, WI 53233-1305

Mailing address

1660 N Prospect Ave Unit 910
Milwaukee, WI 53202-2445
Phone (269) 599-3174

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828005043 WI Practitioner - Registered Dietitian Or Nutrition Professional 7719426154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5186-29WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jun 2, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jun 2, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jun 2, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 2, 2024 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

945 N 12th St
Ste 4602
Milwaukee, WI 53233
Phone (414) 219-7450

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Organizations & group practices 5

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1811771769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 N PROSPECT AVE UNIT 910",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022445",
            "telephone_number": "269-599-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST STE 4602",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SAMANTHA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "5186-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.