Individual provider Active NPI

Samantha Lindsley, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Maple Grove, MN
National Provider Identifier
1881315174
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
12823 Issued in MN
Practice address
15315 Grove Cir N
Maple Grove, MN 55369-4475
Phone
(952) 831-8742
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 12823 MN Primary

Addresses

Primary practice location

15315 Grove Cir N
Maple Grove, MN 55369-4475

Mailing address

500 Big Woods Blvd
Chanhassen, MN 55317-4504
Phone (612) 219-8064

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12823MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Sep 19, 2022 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Clinic CurrentSince Sep 19, 2022 Accepting new patients

Locations

15315 Grove Cir N
Maple Grove, MN 55369
Phone (763) 585-0600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1881315174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BIG WOODS BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174504",
            "telephone_number": "612-219-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15315 GROVE CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694475",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSLEY",
        "first_name": "SAMANTHA",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "12823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.