Samantha J Minnick, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2640 Issued in NE

Practice address

516 W 14TH Ave
Ste 200
Holdrege, NE 68949

Phone

(308) 995-2865

Fax

(308) 995-4127

NPI assigned

Jun 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha J Jorgenson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Phelps Memorial Health Center

  • Rural Health Clinic/Center
  • Holdrege, NE
  • NPI 1891189809
  NPD (past)

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1902065394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "address_2": "STE 2",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-237-7388",
            "fax_number": "308-237-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W 14TH AVE",
            "address_2": "STE 200",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "68949",
            "telephone_number": "308-995-2865",
            "fax_number": "308-995-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "JORGENSON",
            "middle_name": "J",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah McDiarmid
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• Sara Elizabeth McQuistan, CRNA
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• Ana M Medina Espinoza
• Donna Lee Mitchem
• Kameron Joseph Murray, MSPAS
• Larry Lee Myers, RP
• Nebraska Provider Alliance LLC
• Peyton Neff

• Physical Therapist in Holdrege, NE
• Providers in Holdrege, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.