Active NPI
Samantha Christine Pass, RDN, LDN
- Registered Dietitian
- Memphis, TN
National Provider Identifier
1053146555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4037
- Practice address
- 6225 Humphreys Blvd
Memphis, TN 38120-2373 - Phone
- (901) 227-9023
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4037 | TN | Primary |
Addresses
Primary practice location
6225 Humphreys Blvd
Memphis, TN 38120-2373
Mailing address
3179 Shelby St
Bartlett, TN 38134-3435
Phone (901) 483-5774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4037 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1053146555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3179 SHELBY ST",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381343435",
"telephone_number": "901-483-5774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6225 HUMPHREYS BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202373",
"telephone_number": "901-227-9023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASS",
"first_name": "SAMANTHA",
"middle_name": "CHRISTINE",
"name_prefix": "Ms.",
"credential": "RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-04",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "4037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.