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Sue Samuel

Physician β€’ Vail, AZ

Deactivated NPI 1003982646 Deactivated in NPPES Female Practitioner
Practice location in NPPES

13218 E Mineta Ridge Dr
Vail, AZ 856412520

Phone: 5207625072

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of January 01, 2026; the reason is not published. The records below are historical. They do not show whether Sue Samuel currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date November 27, 2006
NPI Deactivation Date January 01, 2026
NPI Active Period 2006 – 2026

Practice Location & Contact Primary Location

Practice Address

13218 E Mineta Ridge Dr

Vail, AZ 856412520

Telephone 5207625072

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Vail and Arizona

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Community Based Residential Treatment Facility, Mental Illness Primary Specialty

NUCC Taxonomy Code: 320800000X

License # reported to NPPES AZ BH-2713

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Arizona Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated January 01, 2026

NPPES lists this NPI as deactivated as of January 01, 2026; the reason is not published.

βœ…
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Practice Location (Initial Record) July 09, 2007

Registered at 13218 E MINETA RIDGE DR, VAIL, AZ 856412520 (Tel: 5207625072)

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Business Mailing Address (Initial Record) July 09, 2007

Registered at 13218 E MINETA RIDGE DR, VAIL, AZ 856412520 (Tel: 5207625072)

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Provider Name / Credentials (Initial Record) July 09, 2007

Recorded as SUE SAMUEL

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Community Based Residential Treatment Facility, Mental Illness (license number reported to NPPES: AZ BH-2713)

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Initial NPI Registration & Enumeration November 27, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1003982646
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 27, 2006
Last Update: July 09, 2007
Deactivation Date: January 01, 2026

Mailing Address

13218 E Mineta Ridge Dr

Vail, AZ 856412520

Phone: 5207625072

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.