Individual provider Active NPI

Samantha Lynn Musser, FNP-C

  • Family Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1174017701
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58914 Issued in ID
Practice address
415 6TH St
Lewiston, ID 83501-2431
Phone
(208) 750-7445
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 58914 ID
Family Medicine Physician 207Q00000X 58914 ID
Family Nurse Practitioner 363LF0000X 58914 ID Primary

Addresses

Primary practice location

415 6TH St
Lewiston, ID 83501-2431

Mailing address

415 6TH St
Lewiston, ID 83501-2431
Phone (208) 750-7379

Other practice location 1

728 Stewart Ave
Lewiston, ID 83501
Phone (208) 553-9250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20180726001298 ID Practitioner - Nurse Practitioner 7416204193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Hospital LLCGroup PAC ID 8325325806, 91 clinicians

Practice addresses (Care Compare)

415 6TH St
Lewiston, ID 83501-2431
Phone (208) 743-2511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
58914IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital LLC CurrentSince Jun 27, 2018 Accepting new patients
Sound Physicians of Idaho Family Medicine CurrentSince Feb 4, 2024 Accepting new patients

Locations

2426 N Merritt Creek Loop
Ste A
Coeur D Alene, ID 83814
Phone (208) 668-7000

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

307 Saint Johns Way
Ste 1
Lewiston, ID 83501
Phone (208) 743-3998

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

Interoperability endpoints

  • Direct secure messaging: samantha.musser.1@12569.direct.athenahealth.com
  • Direct secure messaging: samantha.musser.1@16883.direct.athenahealth.com

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.

Hospital & facility affiliations 5

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1174017701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-750-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-750-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 Stewart Ave",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "83501",
            "country_code": "US",
            "telephone_number": "208-553-9250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSSER",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "ID",
            "license": "58914",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "58914",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "58914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.