JEFFREY SAMELSON (NPI# 1801866223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801866223 |
| Entity Type | Individual |
| Full Name | JEFFREY SAMELSON |
| Credential | PHD |
| Practice Address |
1225 E Coolspring Ave Michigan City IN 46360-6312 |
| Practice Telephone | 2198732964 |
| Practice Fax Number | 2198732933 |
| Mailing Telephone | 2198732964 |
| Mailing Fax Number | 2198732933 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2011-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 20010303A | IN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20010303A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | P00616032 | 01 | |
| IN | ANTHEM | 000000347073 | 01 |
| IN | 100162900 | 05 |
| Street Address |
1225 E COOLSPRING AVE |
| City | MICHIGAN CITY |
| State | IN |
| Zip Code | 46360-6312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508864497 | Stacey Colleen Leva | Family Medicine | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2005-07-13 |
| 1073125076 | Lakeshore Eye Consultants, LLC | Ophthalmology | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2020-08-20 |
| 1518423250 | Molly Majot | Dietitian, Registered | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2019-02-19 |
| 1427556232 | Nikole Pennington | Nurse Practitioner | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2018-01-26 |
| 1174048813 | Anna R Salyer | Occupational Therapist | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2017-08-03 |
| 1538608765 | Emily Walters | Dietitian, Registered | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2017-02-21 |
| 1184172140 | Rita Anne Halac | Nurse Practitioner | 1225 E Coolspring Ave, 2c, Michigan City, IN 46360-6312 | 2016-09-19 |
| 1609233212 | Franciscan Physician Network | Clinic/Center | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2016-01-27 |
| 1528453875 | Jennifer O'dor | Nurse Practitioner | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2015-04-03 |
| 1992101422 | Lauren Ashleigh Geers | Occupational Therapist | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2014-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821649096 | Trinity Healthcare Inc. | Occupational Therapist | 4300 Cleveland Ave, Michigan City, IN 46360 | 2019-09-27 |
| 1861905499 | Erika Leigh Maroon | Chiropractor | 8690 West Pahs Rd., Michigan City, IN 46360 | 2017-11-06 |
| 1750740650 | Michelle Asbell | Nurse Practitioner | 301 Homer St, Michigan City, IN 46360 | 2016-02-19 |
| 1235523952 | Marnee Flinn-smith | Specialist/Technologist | 8466 Pahs Rd, Michigan City, IN 46360 | 2015-03-19 |
| 1184976359 | Kelly Stewart | Physical Therapist | 301 Homer Street, Michigan City, IN 46360 | 2012-10-11 |
| 1053660936 | Planned Parenthood of Indiana Michigan City | Clinic/Center | 324 Dunes Plaza, Michigan City, IN 46360 | 2012-09-06 |
| 1114288644 | June R. R. Nichols Ocularist, Ltd | Durable Medical Equipment & Medical Supplies | 450 St. John Road, Suite 396, Michigan City, IN 46360 | 2012-05-31 |
| 1083980858 | Enoch Kassa | Internal Medicine | 3777 N Frontage Rd, Michigan City, IN 46360 | 2012-03-27 |
| 1760768196 | American Limb & Orthopedic Company of Valparaiso | Prosthetic/Orthotic Supplier | 3777 N. Frontage Rd, Suite 100, Michigan City, IN 46360 | 2011-10-31 |
| 1801181144 | Elizabeth A Whitaker | Counselor | 8733 W. 400 N., 400 North Medical Center, Michigan City, IN 46360 | 2011-06-15 |
| Find all providers in zip 46360 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548595796 | Joseph F Gazarkiewicz | Psychologist | 1411 S. Woodland Avenue, Suite B, Michigan City, IN 46360-7170 | 2009-10-06 |
| 1265595854 | Janice Englander Katz | Psychologist | 831 Washington St, Michigan City, IN 46360-3509 | 2006-12-18 |
| 1457429722 | John Alexander Israel | Psychologist | 1401 S Woodland Ave Ste 3, Michigan City, IN 46360-7189 | 2006-12-02 |
| 1174897003 | A New Focus Psychological Services, P.C. | Psychologist | 1411 S. Woodland Avenue, Suite B, Michigan City, IN 46360 | 2012-02-23 |
| 1447348651 | Tamara Ann Miller | Psychologist | 2814 Franklin St, Michigan City, IN 46360-6140 | 2006-10-11 |
| 1063483758 | Earle Clifton Titus | Psychologist | 450 Saint John Rd, Michigan City, IN 46360-7354 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196842 | Ariel C Breaux | Psychologist | 800 Bus Stop Dr, Madison, IN 47250 | 2020-08-28 |
| 1841816048 | Christina E Maxwell Phd | Psychologist | 6337 Hollister Driive, Suite 101, Indianapolis, IN 46224-2996 | 2020-06-23 |
| 1154942340 | Craig Allan Nordstrom | Psychologist | 111 E Clearwater Ave, Beverly Shores, IN 46301-0056 | 2020-04-29 |
| 1164052791 | Kadlec Consulting Services, LLC | Psychologist | 5525 Oak Valley Pl, Fort Wayne, IN 46845-1836 | 2020-01-23 |
| 1568001469 | Monica Anne Cotter | Psychologist | Adam Benjamin Jr. Va Outpatient Clinic, 9301 Madison, Crown Point, IN 46307-4630 | 2019-12-26 |
| 1417505538 | John Pierre Rudy | Psychologist | 3464 Cinnamon Trce, Kokomo, IN 46901-3981 | 2019-09-02 |
| 1265995500 | Jamie Garvey | Psychologist | Saint Liam Hall, 220 Main Buildig, Notre Dame, IN 46556 | 2019-04-12 |
| 1902362619 | Geoffrey Edwards Buck | Psychologist | 9245 N Meridian St # 111, Indianapolis, IN 46260-1836 | 2019-02-18 |
| 1447722483 | Steven James Eckert | Psychologist | 4700 Bureau Rd N, Terre Haute, IN 47802-8246 | 2018-12-31 |
| 1215403167 | Sean Kristen Jones | Psychologist | 11725 N Illinois St Ste 355, Carmel, IN 46032-3009 | 2018-10-18 |
| Find all providers with the same taxonomy | ||||
| City | MICHIGAN CITY |
| Zip Code | 46360 |
Please comment or provide details below to improve the information on JEFFREY SAMELSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.