Samantha Ann Fisher, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-1162 Issued in ID

Practice address

30544 Highway 200 Ste 103
Ponderay, ID 83852-5005

Phone

(208) 946-5110

NPI assigned

Dec 2, 2020

Last updated

Nov 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Ann Buratto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael R Dibenedetto MD PLLC

  dba North Idaho Cardiac Rehabilitation

  • Orthopaedic Surgery Physician
  • Ponderay, ID
  • NPI 1083809727
  NPD (past)

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1699370064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1633",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640870",
            "telephone_number": "208-290-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30544 HIGHWAY 200 STE 103",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838525005",
            "telephone_number": "208-946-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-1162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BURATTO",
            "middle_name": "ANN",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eden Home Health of Sandpoint, LLC (Eden Home Health)
• Eden Hospice at the Inland Northwest, LLC (Eden Hospice)
• Arleen Mae Erland
• Ew Anesthesia PLLC
• Jonathan Donald Fisher, DPM
• Thomas G Fletcher, M.D.
• Foster Holdings LTD (Well Life Sand Creek Pharmacy)
• Kathy Gavin, FNP
• Glacier Prosthetic Care, Inc.
• Rebecca Goebel, LMT

• Registered Dietitian in Ponderay, ID
• Providers in Ponderay, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.