Individual provider Active NPI

Lauren Sams, MS, RD, IBCLC

  • Pediatric Nutrition Registered Dietitian
  • Waco, TX
National Provider Identifier
1134596158
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
DT96469 Issued in TX
Practice address
6704 Woodway Dr
Waco, TX 76712-6145
Phone
(254) 892-4957
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L305319 TX
Pediatric Nutrition Registered Dietitian 133VN1004X DT96469 TX Primary

Addresses

Primary practice location

6704 Woodway Dr
Waco, TX 76712-6145

Mailing address

6704 Woodway Dr
Waco, TX 76712-6145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2023 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT96469TXMDPediatric Nutrition Registered Dietitian
1390SCMDOptician
L305319TXMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
Compleo Physical Therapy & Wellness LLC CurrentSince Jun 9, 2024 Accepting new patients
Lauren Sams Nutrition and Lactation Dietitian, Registered Current Accepting new patients

Locations

6704 Woodway Dr
Woodway, TX 76712
Phone (254) 366-3662

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1134596158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6704 WOODWAY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6704 WOODWAY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126145",
            "telephone_number": "254-892-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "LAUREN",
        "credential": "MS, RD, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "TX",
            "license": "L305319",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DT96469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.