Individual provider Active NPI

Samantha Ruth Wurth, FNP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1821723727
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021871 Issued in CA
Practice address
3000 Q St FL 4
Sacramento, CA 95816-7058
Phone
(916) 733-3401
Fax
(916) 452-1075
NPI assigned
Jul 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X 95021871 CA
Family Nurse Practitioner 363LF0000X 95021871 CA Primary

Addresses

Primary practice location

3000 Q St FL 4
Sacramento, CA 95816-7058

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Other names 1

  • Samantha Ruth Lee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220817001215 CA Practitioner - Nurse Practitioner 8325421761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

3000 Q St
FL 4
Sacramento, CA 95816-7058
Phone (916) 560-0319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95021871CAMDCommunity Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Wellspace Health CurrentSince Aug 15, 2022 Accepting new patients
Wellspace Health Current Accepting new patients
Wellspace Health CurrentSince Aug 15, 2022 Accepting new patients
Dignity Health Medical Foundation CurrentSince Dec 26, 2023 Accepting new patients
Dignity Health Medical Foundation CurrentSince Dec 26, 2023 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

8220 Wymark Dr
Ste 200
Elk Grove, CA 95757
Phone (916) 667-0600

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

8233 E Stockton Blvd
Ste D
Sacramento, CA 95828
Phone (916) 236-4700

3000 Q St
Fl 4
Sacramento, CA 95816
Phone (916) 733-5700

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

Organizations & group practices 7

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": "1658620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1821723727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 Q ST FL 4",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167058",
            "telephone_number": "916-733-3401",
            "fax_number": "916-452-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURTH",
        "first_name": "SAMANTHA",
        "middle_name": "RUTH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "CA",
            "license": "95021871",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LEE",
            "middle_name": "RUTH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.