Samantha Leigh Clark, C-PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

10047719 Issued in OR

Practice address

4904 River Rd N
Keizer, OR 97303-4540

Phone

(503) 390-2434

NPI assigned

Nov 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Little Critters Pediatrics LLC

  • Pediatrics Physician
  • Keizer, OR
  • NPI 1932082872
  NPD
• Small Town Pediatrics LLC

  • Pediatrics Physician
  • Silverton, OR
  • NPI 1134799489
  NPD (past)

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1841908894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034540",
            "telephone_number": "503-390-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034540",
            "telephone_number": "503-390-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMANTHA",
        "middle_name": "LEIGH",
        "credential": "C-PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "10047719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirosession LLC
• Christopher Scott
• Crystal Cida Guzman, PT
• Cindy Bowling RN Pmhnp PC Inc
• Cyruss Austin Clark
• Cochrun Medical Management
• Bryan Codina
• Sarah N Collins
• Consolidated Vision Group
• Katherine M Cooper Compton, LMT

• Pediatric Nurse Practitioner in Keizer, OR
• Providers in Keizer, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.