Samantha Jo Dates, - Licensed Practical Nurse in Randolph, WI

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Samantha Jo Dates, is a Licensed Practical Nurse based in Randolph, Wisconsin. Samantha Jo Dates is licensed to practice in Wisconsin (license number 325608) and her current practice location is N8273 E Friesland Rd, Randolph, Wisconsin. She can be reached at her office (for appointments etc.) via phone at (920) 296-7067.

NPI number for Samantha Jo Dates is 1538767355 and her current mailing address is N8273 E Friesland Rd, Randolph, Wisconsin. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1538767355.

Contact Information

Samantha Jo Dates,
N8273 E Friesland Rd,
Randolph, WI 53956-9407
(920) 296-7067
Not Available

Map and Direction




Provider's Profile

Full NameSamantha Jo Dates
GenderFemale
SpecialityLicensed Practical Nurse
LocationN8273 E Friesland Rd, Randolph, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1538767355
  • Provider Enumeration Date: 10/14/2020
  • Last Update Date: 10/14/2020

Medical Identifiers

Medical identifiers for Samantha Jo Dates such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538767355NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
164W00000XLicensed Practical Nurse 325608 (Wisconsin)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Jo Dates is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samantha Jo Dates,
N8273 E Friesland Rd,
Randolph, WI 53956-9407

Ph: (920) 296-7067		Samantha Jo Dates,
N8273 E Friesland Rd,
Randolph, WI 53956-9407

Ph: (920) 296-7067

Reviews and Comments


Licensed Practical Nurse Nurses in Randolph, WI


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.