Individual provider Active NPI

Samantha Todd, ARNP

  • Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1366843088
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60477359 Issued in WA
Practice address
9911 N Nevada St
Spokane, WA 99218-1298
Phone
(509) 626-9420
Fax
(509) 227-7070
NPI assigned
Sep 12, 2014
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60477359 WA Primary
Family Nurse Practitioner 363LF0000X AP60477359 WA

Addresses

Primary practice location

9911 N Nevada St
Spokane, WA 99218-1298

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other practice location 1

6240 Tacoma Mall Blvd Ste 101
Tacoma, WA 98409-6819
Phone (532) 719-7202

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stodd218525@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150423001581 WA Practitioner - Nurse Practitioner 3870712037 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dispatchhealth Washington PC CurrentSince Aug 20, 2020 Accepting new patients

Locations

1411 4th Ave
Seattle, WA 98101
Phone (253) 271-9720

6240 Tacoma Mall Blvd
Ste 101
Tacoma, WA 98409
Phone (253) 271-9720

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, 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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1366843088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9911 N NEVADA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181298",
            "telephone_number": "509-626-9420",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6240 Tacoma Mall Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984096819",
            "country_code": "US",
            "telephone_number": "532-719-7202",
            "fax_number": "253-212-3372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "SAMANTHA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60477359",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60477359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stodd218525@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "105 E Mission Ave Ste D",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992026002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.