Individual provider Active NPI

Samantha Stough, RD, CSG

  • Gerontological Nutrition Registered Dietitian
  • Yuba City, CA
National Provider Identifier
1245941095
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontological Nutrition Registered DietitianTaxonomy code 133VN1101X
License
86014476 Issued in CA
Practice address
481 Plumas Blvd Ste 202
Yuba City, CA 95991-5075
Phone
(530) 749-2409
Fax
(530) 751-4973
NPI assigned
Dec 12, 2022
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86014476 AZ
Gerontological Nutrition Registered Dietitian 133VN1101X 86014476 CA Primary

Addresses

Primary practice location

481 Plumas Blvd Ste 202
Yuba City, CA 95991-5075

Mailing address

481 Plumas Blvd Ste 202
Yuba City, CA 95991-5075
Phone (530) 749-2409

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230207002748 CA Practitioner - Registered Dietitian Or Nutrition Professional 0143692707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86014476AZMDRegistered Dietitian
86014476CAMDGerontological Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jan 20, 2023 Accepting new patients
Adventist Health Physicians Network CurrentSince Jan 20, 2023 Accepting new patients

Locations

1007 Live Oak Blvd
Ste B2
Yuba City, CA 95991
Phone (530) 671-8718

481 Plumas Blvd
Ste 202
Yuba City, CA 95991
Phone (530) 674-2851

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1245941095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 PLUMAS BLVD STE 202",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959915075",
            "telephone_number": "530-749-2409",
            "fax_number": "530-751-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 PLUMAS BLVD STE 202",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959915075",
            "telephone_number": "530-749-2409",
            "fax_number": "530-751-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUGH",
        "first_name": "SAMANTHA",
        "credential": "RD, CSG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86014476",
            "primary": false
        },
        {
            "code": "133VN1101X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": "CA",
            "license": "86014476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.