Terry J Samuels, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301072270 Issued in MI

Practice address

1250 Lears Rd
Petoskey, MI 49770-8774

Phone

(231) 242-1700

Fax

(231) 242-1717

NPI assigned

Jul 21, 2006

Last updated

Jan 29, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Family Practice

Education

University of Michigan Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Little Traverse Bay Bands of Odawa IndiansGroup PAC ID 8820995368, shared by 2 NPIs, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1881615391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 LEARS RD",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709252",
            "telephone_number": "231-242-1700",
            "fax_number": "231-242-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 LEARS RD",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708774",
            "telephone_number": "231-242-1700",
            "fax_number": "231-242-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "TERRY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301072270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104385906",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Martin Rousseau, MSW, LBSW, CAADC
• Janelle Routhier, O.D
• Natalia I Rush, M.D.
• Elizabeth Louise Russ, AGACNP
• David Joel Rynbrandt, MD
• Jeffrey A Samyn, PT
• Thomas Lee Sandison, R.PH.
• Jon A Sangeorzan, M.D.
• Joshua W Saur, D.O.
• Josie Kleinert Schafer, LPC

• Family Medicine Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.