Active NPI
Samantha Prentiss, RDN, LD
- Registered Dietitian
- Lawrence, KS
National Provider Identifier
1275164774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT85130
- Practice address
- 828 Mulberry Dr
Lawrence, KS 66049-4701 - Phone
- (203) 801-8030
- NPI assigned
- Feb 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT85130 | TX | Primary |
Addresses
Primary practice location
828 Mulberry Dr
Lawrence, KS 66049-4701
Mailing address
3724 Jefferson St
Austin, TX 78731-6225
Phone (512) 692-7045
Other names 1
- Mrs. Samantha Prentiss
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1580688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1275164774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3724 JEFFERSON ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787316225",
"telephone_number": "512-692-7045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 MULBERRY DR",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660494701",
"telephone_number": "203-801-8030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENTISS",
"first_name": "SAMANTHA",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-03",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT85130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "PRENTISS",
"prefix": "MRS.",
"credential": "RDN, LD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.