Active NPI
Samantha Sanner, MBA, RDN, LDN
- Registered Dietitian
- Palmyra, VA
National Provider Identifier
1619402831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5274
- Practice address
- 6 Centre CT
Palmyra, VA 22963-2329 - Phone
- (412) 215-9428
- NPI assigned
- Apr 25, 2017
- 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 | ND8516 | FL | |
| Registered Dietitian | 133V00000X | 5274 | TN | Primary |
Addresses
Primary practice location
6 Centre CT
Palmyra, VA 22963-2329
Mailing address
720 Mount Vernon Ave
Chattanooga, TN 37405-2935
Phone (412) 215-9428
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
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5274 | TN | MD | Professional Counselor |
| ND8516 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1493078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746144000000",
"number": "1619402831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 MOUNT VERNON AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374052935",
"telephone_number": "412-215-9428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CENTRE CT",
"city": "PALMYRA",
"state": "VA",
"postal_code": "229632329",
"telephone_number": "412-215-9428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANNER",
"first_name": "SAMANTHA",
"credential": "MBA, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-25",
"last_updated": "2025-05-02",
"certification_date": "2025-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND8516",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "5274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmyra, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.