Individual provider Active NPI

Samara Loren Stevens, ND

  • Naturopath
  • Portland, OR
National Provider Identifier
1780189332
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
4174 Issued in OR
Practice address
6110 N Lombard St Ste B
Portland, OR 97203-4122
Phone
(503) 897-9711
Fax
(503) 854-0194
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 4174 OR Primary

Addresses

Primary practice location

6110 N Lombard St Ste B
Portland, OR 97203-4122

Mailing address

6110 N Lombard St Ste B
Portland, OR 97203-4122
Phone (503) 897-9711

Other identifiers 1

IdentifierTypeStateIssuer
500753516MedicaidOR

Other names 1

  • Samara Loren Simpson Former name

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
4174ORMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Mental Health, LLC Naturopath CurrentSince Sep 4, 2022 Accepting new patients

Locations

6110 N Lombard St
#B
Portland, OR 97203
Phone (503) 897-9711

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEDECD/Endpoint/CEDECD

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1780189332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 N LOMBARD ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034122",
            "telephone_number": "503-897-9711",
            "fax_number": "503-854-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 N LOMBARD ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034122",
            "telephone_number": "503-897-9711",
            "fax_number": "503-854-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SAMARA",
        "middle_name": "LOREN",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500753516",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMARA",
            "last_name": "SIMPSON",
            "middle_name": "LOREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 4, 2024; 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.