Active NPI
Samantha Rongstad, RDN
- Registered Dietitian
- Joint Base Lewis McChord, WA
National Provider Identifier
1427796929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 9040 Jackson Ave RM 1-27-12
Joint Base Lewis McChord, WA 98431-0001 - Phone
- (253) 968-6337
- NPI assigned
- May 24, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1299 | ND | |
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
9040 Jackson Ave RM 1-27-12
Joint Base Lewis McChord, WA 98431-0001
Mailing address
9040 Jackson Ave RM 1-27-12
Joint Base Lewis McChord, WA 98431-0001
Phone (253) 968-6337
Other practice location 1
4401 S 11th St
Grand Forks, ND 58201
Phone (701) 732-7620
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1299 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1427796929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE RM 1-27-12",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-6337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE RM 1-27-12",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-6337"
}
],
"practiceLocations": [
{
"address_1": "4401 S 11th St",
"address_purpose": "LOCATION",
"city": "Grand Forks",
"state": "ND",
"postal_code": "58201",
"country_code": "US",
"telephone_number": "701-732-7620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RONGSTAD",
"first_name": "SAMANTHA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-24",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "1299",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joint Base Lewis McChord, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.