Individual provider Active NPI

Catherine Lott Samson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1710075221
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200650006NP Issued in OR
Practice address
2455 NW Marshall St
Suite 14
Portland, OR 97210-2949
Phone
(503) 679-6470
Fax
(503) 296-2996
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200650006NP OR Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30007493 WA

Addresses

Primary practice location

2455 NW Marshall St
Suite 14
Portland, OR 97210-2949

Mailing address

2455 NW Marshall St
Suite 14
Portland, OR 97210-2949
Phone (503) 679-6470

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

LicenseStateTypeSpecialty
200650006NPORMDPsychiatric/Mental Health Nurse Practitioner
AP30007493WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catherine Samson, Pmhnp, LLC Psychiatric/Mental Health 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1710075221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 NW MARSHALL ST",
            "address_2": "SUITE 14",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102949",
            "telephone_number": "503-679-6470",
            "fax_number": "503-296-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 NW MARSHALL ST",
            "address_2": "SUITE 14",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102949",
            "telephone_number": "503-679-6470",
            "fax_number": "503-296-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "CATHERINE",
        "middle_name": "LOTT",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200650006NP",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30007493",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.