Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicholas Sample, CAA

Individual provider Athletic Trainer · NPI 1205236031

Nicholas Sample, CAA is an Anesthesiology Assistant in LA Crosse, Wisconsin. Qualified in 2021, 5 years ago. Practices with Gundersen Lutheran Medical Center Inc, a 896-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

1836 S Ave
LA Crosse, WI 54601-5429
Phone: (608) 782-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 537 Crown Pointe Estates Ct, Wildwood, MO 63021-2012 — (314) 971-5488

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 195-17 (WI)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1205236031
Entity typeIndividual (Type 1)
GenderMale
Credentials CAA
Sole proprietorNo
NPI enumeratedAugust 29, 2014
Last updated in NPPESOctober 29, 2021
Certification dateOctober 29, 2021
Mailing address1836 South Ave, La Crosse, WI 54601-5429

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Gundersen Lutheran Medical Center Inc — 896 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in LA Crosse