Denise Anne Sample, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5005063 Issued in NC

Practice address

834 Sheridan St
Port Townsend, WA 98368

Phone

(360) 385-2200

NPI assigned

Jan 26, 2011

Last updated

May 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, WA, TX, GA, MI, CO, KY7 enrollments

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 7

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: denise.sample.1@13711.direct.athenahealth.com
• Direct secure messaging: denise.sample.1@19654.direct.athenahealth.com
• Direct secure messaging: denise.sample.1@21533.direct.athenahealth.com
• Direct secure messaging: denise.sample.1@21803.direct.athenahealth.com
• Direct secure messaging: denise.sample.1@22064.direct.athenahealth.com
• Direct secure messaging: dsample863703@wm.providencedirect.org
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71750

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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group NPD
• Villagemd of Southeast Texas, PA

  • Family Medicine Physician
  • Houston, TX
  • NPI 1841643327

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Medicare reassignment NPD
• Qcpi-Villagemd, PC

  dba Village Medical

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment NPD
• VMD Primary Providers Central Kentucky

  • Internal Medicine Physician
  • Murray, KY
  • NPI 1831674654

  Nurse Practitioner

  Medicare reassignment NPD
• VMD Primary Providers Colorado, Inc

  • Primary Care Clinic/Center
  • Fort Collins, CO
  • NPI 1275646614
  Medicare reassignment NPD
• VMD Primary Providers Eastern Michigan, PC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1336625540
  Medicare reassignment NPD
• Sound Integrated Health LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Tacoma, WA
  • NPI 1558885210
  Medicare reassignment
• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare Townsend Clinic

  • Rural Health Clinic/Center
  • Port Townsend, WA
  • NPI 1952353369
  NPD
• Cigna Health Care of Arizona Inc

  dba EVERNORTH Care Group Stapley Multi-Specialty Center

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1528139953
  NPD
• Cigna Healthcare of Arizona, Inc.

  dba EVERNORTH Care Group

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1073626404
  NPD
• Primary Care Medical Center Inc

  • Family Medicine Physician
  • Murray, KY
  • NPI 1295716694
  NPD

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1083919898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-385-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 James St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981045102",
            "country_code": "US",
            "telephone_number": "206-464-1570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "834 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "98368",
            "country_code": "US",
            "telephone_number": "360-385-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "DENISE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005063",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005925",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Jean Ryan, RPH
• Shannon Elizabeth Ryan, LMP
• Safe Harbor Recovery Center
• Safeway Inc (Safeway Pharmacy #0538)
• Sammi Bair-Jones Physical Therapy, PLLC
• Heather Sanders, LMT
• Mark Saran, LMHC
• Edward Paul Savidge, DDS
• Jennifer Lynn Sayles, ARNP
• Jean Armstrong Scarboro, LMHC

• Family Nurse Practitioner in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.