Active NPI
Gregg Orville Sampson, PT
- Physical Therapist
- Poulsbo, WA
National Provider Identifier
1497830426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002874
- Practice address
- 1015 NE Hostmark St
Suite #101
Poulsbo, WA 98370-6204 - Phone
- (360) 697-7726
- Fax
- (360) 697-7728
- NPI assigned
- Oct 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00002874 | WA | Primary |
Addresses
Primary practice location
1015 NE Hostmark St
Suite #101
Poulsbo, WA 98370-6204
Mailing address
9621 Ridgetop Blvd NW
Suite #100
Silverdale, WA 98383-8502
Phone (360) 337-7662
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91181639721 | Other | WA | KPS |
| 9187607 | Other | WA | CIGNA |
| 8345118 | Medicaid | WA |
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 |
|---|---|---|---|
| Sampson Enterprises Inc | Physical Therapist | 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, 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": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497830426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9621 RIDGETOP BLVD NW",
"address_2": "SUITE #100",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838502",
"telephone_number": "360-337-7662",
"fax_number": "360-337-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 NE HOSTMARK ST",
"address_2": "SUITE #101",
"city": "POULSBO",
"state": "WA",
"postal_code": "983706204",
"telephone_number": "360-697-7726",
"fax_number": "360-697-7728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "GREGG",
"middle_name": "ORVILLE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002874",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KPS",
"identifier": "91181639721",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9187607",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8345118",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.