Individual provider Active NPI

Samantha Ashley Nickelson, DC

  • Chiropractor
  • Denton, TX
National Provider Identifier
1982581245
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16578 Issued in TX
Practice address
1504 Paco TRL
Denton, TX 76209-4644
Phone
(940) 435-1164
Fax
(940) 213-1601
NPI assigned
Aug 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16578 TX Primary

Addresses

Primary practice location

1504 Paco TRL
Denton, TX 76209-4644

Mailing address

1504 Paco TRL
Denton, TX 76209-4644
Phone (940) 435-1164

Other names 1

  • Samantha Ashley Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16578TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nickelson Family Chiropractic Professional Limited Liability Com Chiropractor CurrentSince Dec 7, 2025 Accepting new patients

Locations

314 S Shady Shores Dr
Ste 100
Lake Dallas, TX 75065
Phone (940) 363-1039

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1982581245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 PACO TRL",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094644",
            "telephone_number": "940-435-1164",
            "fax_number": "940-213-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 PACO TRL",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094644",
            "telephone_number": "940-435-1164",
            "fax_number": "940-213-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELSON",
        "first_name": "SAMANTHA",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "16578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "MILLER",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.