Thomandra Shavaun Sam, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0005019 Issued in CO

Practice address

3600 S Beeler St Ste 110
Denver, CO 80237-1802

Phone

(720) 347-8559

NPI assigned

Feb 24, 2011

Last updated

Jul 27, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomandra.shavaun.sam.1@30520.direct.athenahealth.com
• Direct secure messaging: tsam5166709@direct.casso.us.com

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.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943
  Medicare reassignment Care Compare group NPD
• Dr. K's Family Medicine

  • Rural Health Clinic/Center
  • Bogalusa, LA
  • NPI 1265971147
  Medicare reassignment NPD
• Our Lady of the Lake Physician Group LLC

  dba Our Lady of the Lake Children's Health Developmental Center at McMains

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group, LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1588062079
  NPD
• Our Lady of the Lake Physician Group LLC

  dba OLOL Physician Surgical Specialty

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455
  NPD (past)

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1477850667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11402 GALWAY GROVE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770471540",
            "telephone_number": "337-351-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S BEELER ST STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802371802",
            "telephone_number": "720-347-8559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "576 Desiree Rd",
            "address_purpose": "LOCATION",
            "city": "Opelousas",
            "state": "LA",
            "postal_code": "705701350",
            "country_code": "US",
            "telephone_number": "337-351-6561",
            "fax_number": "828-227-7004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6400 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084124",
            "country_code": "US",
            "telephone_number": "225-330-0497",
            "fax_number": "225-330-0498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20971 E Smoky Hill Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800155187",
            "country_code": "US",
            "telephone_number": "720-347-8559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "685 Citadel Dr E Ste 325",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095326",
            "country_code": "US",
            "telephone_number": "720-347-8559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "THOMANDRA",
        "middle_name": "SHAVAUN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-24",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "0005019",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsam5166709@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tsam5166709@direct.casso.us.com",
            "address_1": "6400 Perkins Rd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6400 Perkins Rd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Marie Saluke, M.D.
• Lauren Salvador, MS - SLP
• Paul A Salyers
• Henry F Salzmann, NP
• Sam Clinic
• Sam's Club Optical (Sam's Club Optical 30-4777)
• Sam's Club Optical (Sam's Club Optical 30-6632)
• Sam's Club Optical (Sam's Club Optical 30-6635)
• Ariel Samach, NP
• Akanksha Samal, DO

• Psychologist in Denver, CO
• Providers in Denver, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.