Individual provider Active NPI

Samantha Huron, DNP, CRNA, APRN

  • Certified Registered Nurse Anesthetist
  • Kenosha, WI
National Provider Identifier
1942954672
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
15730 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-5600
Fax
(262) 948-5735
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 11019602 FL
Certified Registered Nurse Anesthetist 367500000X 15730 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

3500 E Fletcher Ave Ste 205
Tampa, FL 33613-4795
Phone (813) 615-7294

Other identifiers 1

IdentifierTypeStateIssuer
100303527MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220620001298 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204215353
I20250113003038 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204215353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of South Florida College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

Hospital & facility affiliations

  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11019602FLMDCertified Registered Nurse Anesthetist
15730WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 24, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 24, 2025 Accepting new patients

Locations

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1942954672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-5600",
            "fax_number": "262-948-5735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 E Fletcher Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336134795",
            "country_code": "US",
            "telephone_number": "813-615-7294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURON",
        "first_name": "SAMANTHA",
        "credential": "DNP, CRNA, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11019602",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "15730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100303527",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.