Individual provider Active NPI

Samantha Jo Rasmussen

  • Family Nurse Practitioner
  • Goddard, KS
National Provider Identifier
1073465191
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-84516 Issued in KS
Practice address
1044 N Casado CT
Goddard, KS 67052-9577
Phone
(316) 371-9771
NPI assigned
Feb 11, 2026
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-84516 KS Primary

Addresses

Primary practice location

1044 N Casado CT
Goddard, KS 67052-9577

Mailing address

1044 N Casado CT
Goddard, KS 67052-9577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260420000332 KS Practitioner - Nurse Practitioner 3870069644 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Medical II LLCGroup PAC ID 4284175589, 13 clinicians

Practice addresses (Care Compare)

345 N Riverview St
Suite 412
Wichita, KS 67203-4202
Phone (316) 616-1055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-84516KSMDFamily Nurse Practitioner

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1073465191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 N CASADO CT",
            "city": "GODDARD",
            "state": "KS",
            "postal_code": "670529577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N CASADO CT",
            "city": "GODDARD",
            "state": "KS",
            "postal_code": "670529577",
            "telephone_number": "316-371-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-84516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goddard, KS

Sources for this page

Verify at the official NPI Registry.