Active NPI
Richard Paul Sampson, R.N.,D.C.,F.I.A.M.A.
- Chiropractor
- Meridian, ID
National Provider Identifier
1174517858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA 470
- Practice address
- 1504 N Main St
Meridian, ID 83642-1707 - Phone
- (208) 888-2267
- Fax
- (208) 288-0260
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA 470 | ID | Primary |
| Acupuncturist | 171100000X | ACC-57 | ID |
Addresses
Primary practice location
1504 N Main St
Meridian, ID 83642-1707
Mailing address
1504 N Main St
Meridian, ID 83642-1707
Phone (208) 888-2267
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010007712 | Other | ID | BLUE SHIELD |
| 001618100 | Medicaid | ID | |
| C470-2 | Other | ID | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA 470 | ID | MD | Chiropractor |
| ACC-57 | ID | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277683200000",
"number": "1174517858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1504 N MAIN ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421707",
"telephone_number": "208-888-2267",
"fax_number": "208-288-0260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 N MAIN ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421707",
"telephone_number": "208-888-2267",
"fax_number": "208-288-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "RICHARD",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "R.N.,D.C.,F.I.A.M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2010-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA 470",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "ID",
"license": "ACC-57",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010007712",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001618100",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "C470-2",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.