Individual provider Active NPI

Samantha Suzanne Kingry, RD, CD

  • Registered Dietitian
  • Bellevue, WA
National Provider Identifier
1730779836
Registry record updated Nov 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86116317
Practice address
1231 116TH Ave NE Ste 370800
Bellevue, WA 98004-3804
Phone
(425) 454-1010
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86116317 Primary
Registered Dietitian 133V00000X DI61204883 WA

Addresses

Primary practice location

1231 116TH Ave NE Ste 370800
Bellevue, WA 98004-3804

Mailing address

8704 Greenwood Ave N Apt 417
Seattle, WA 98103-5691
Phone (210) 683-4812

Other practice location 1

8704 Greenwood Ave N Apt 417
Seattle, WA 98103-5691
Phone (210) 683-4812

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

State licenses

LicenseStateTypeSpecialty
DI61204883WAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762041600000",
    "number": "1730779836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8704 GREENWOOD AVE N APT 417",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035691",
            "telephone_number": "210-683-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE STE 370800",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043804",
            "telephone_number": "425-454-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8704 Greenwood Ave N Apt 417",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981035691",
            "country_code": "US",
            "telephone_number": "210-683-4812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINGRY",
        "first_name": "SAMANTHA",
        "middle_name": "SUZANNE",
        "credential": "RD, CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2025-11-02",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86116317",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61204883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

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

Verify at the official NPI Registry.