Nicolle Renea Samuels, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9734 Issued in WI

Practice address

1222 E Woodland Ave
Barron, WI 54812-1765

Phone

(715) 838-5222

NPI assigned

Feb 9, 2006

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 identifiers 1

Other names 1

• Nicolle Renea Schamp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18208/brand/1/csg/1/fhir/r4

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.

• Elite Therapy Institute LLC

  • Physical Therapy Clinic/Center
  • Rice Lake, WI
  • NPI 1760576789

  Physical Therapist

  NPD (past)
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932172129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121765",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121765",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "NICOLLE",
        "middle_name": "RENEA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "9734",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLLE",
            "last_name": "SCHAMP",
            "middle_name": "RENEA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Payton Rudiger, OT
• James A Rugowski, MD
• Lindsey Marie Ruppel, D.O.
• Kelly O'Keefe Salfiti, M.D.
• Richard R Sampson, MD
• Rebecca Sue Sarauer, PA-C
• Stephanie Schafer Zemke
• Jeanne Hovde Schullo, MSW
• Mark A. Schumaker, DPM
• Michael Sciotto, PA-C

• Physical Therapist in Barron, WI
• Providers in Barron, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.