Ian Samuelson, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-121085 Issued in AL

Practice address

1005 W Market St Ste 7
Athens, AL 35611-2454

Phone

(256) 233-9273

Fax

(256) 216-9192

NPI assigned

May 16, 2014

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

Medicare fee-for-service enrollment

Enrolled in AL, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• HH Heart Center, LLC

  • Clinical Cardiac Electrophysiology Physician
  • Huntsville, AL
  • NPI 1255781415
  Medicare reassignment NPD
• Wellbe Utah LLC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568183523

  UT

  Medicare reassignment NPD

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1932510534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 W MARKET ST STE 7",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112454",
            "telephone_number": "256-233-9273",
            "fax_number": "256-216-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W MARKET ST STE 7",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112454",
            "telephone_number": "256-233-9273",
            "fax_number": "256-216-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "IAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-121085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royse Family Medicine
• Laci Russ, RN, IBCLC
• Allison Shull Russell, FNP
• Shakira R Ryan, MS
• Bhagabat C Sahu, M.D., M.S., P.C.
• Jenifer Gail Sanders, BSN RN (NP STUDENT)
• Robert Sandlin, OD
• Ranelda Lea Scales, BS
• Kayla Schell, DMD
• Albert H Scherff III, MD

• Nurse Practitioner in Athens, AL
• Providers in Athens, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.