Organization Active NPI

Samadhi Center, P.C.

  • Psychologist
  • Soldotna, AK
National Provider Identifier
1164522611
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SAMADHI CENTER, P.C.
Practice address
174 E Redoubt Ave
Soldotna, AK 99669-8012
Phone
(907) 262-1260
Fax
(907) 262-4403
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kathleen L Dinius, PH.D.NPI 1669564068
Title
President
Phone
(907) 262-1260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

174 E Redoubt Ave
Soldotna, AK 99669-8012

Mailing address

174 E Redoubt Ave
Soldotna, AK 99669-8012
Phone (907) 262-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728001533 AK Part B Supplier - Clinic/Group Practice 2769452515 Receives reassigned benefits from 1 practitioner
Practice locations: Sterling, AK

National Provider Directory

National Provider Directory

Locations

174 E Redoubt Ave
Soldotna, AK 99669
Phone (907) 262-1260

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164522611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 E REDOUBT AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698012",
            "telephone_number": "907-262-1260",
            "fax_number": "907-262-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 E REDOUBT AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698012",
            "telephone_number": "907-262-1260",
            "fax_number": "907-262-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMADHI CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DINIUS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-262-1260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.