SAMUEL DAVID GJERSET VANDEHAAR
NPI 1376033126
Specialist/Technologist - Athletic Trainer in Mequon, WI

Q: What is Samuel Vandehaar's NPI number?

The NPI number for Samuel Vandehaar is 1376033126. It was assigned to this individual provider in the NPPES registry on May 17, 2018.

Q: What is Samuel Vandehaar's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Vandehaar was last updated on May 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 17, 2018

12800 N LAKE SHORE DR, MEQUON, WI 53097(715) 944-9037 Get Directions Write a Review

NPPES record last updated: May 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Samuel David Gjerset Vandehaar NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL DAVID GJERSET VANDEHAAR (NPI 1376033126) is an individual athletic trainer provider in Mequon, Wisconsin and active in the NPI registry since May 2018.

NPPES Registry Identity

NPI1376033126

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameSAMUEL DAVID GJERSET VANDEHAAR

Location Address12800 N LAKE SHORE DRMequon, WI 53097-2418

Mailing Address1737 Brickyard LnChippewa Falls, WI 54729-2294 · (715) 944-9037

Phone(715) 944-9037

Sole ProprietorNo

Enumeration DateMay 17, 2018

✔ NPI 1376033126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

12800 N LAKE SHORE DR, Mequon, WI 53097

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA ESSEX

Student in an Organized Health Care Education/Training Program