Active NPI
Martha Larose Sampson, CRNA
- Certified Registered Nurse Anesthetist
- Worcester, MA
National Provider Identifier
1891797361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN115845
- Practice address
- 55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002 - Phone
- (508) 334-3271
- Fax
- (508) 856-5911
- NPI assigned
- Aug 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN115845 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002
Mailing address
258 W Main St
Millbury, MA 01527-1423
Phone (508) 865-0262
Other names 1
- Martha Larosesampson
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
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115845 | MA | MD | Clinical Social Worker |
| RN115845 | MA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1891797361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 W MAIN ST",
"city": "MILLBURY",
"state": "MA",
"postal_code": "015271423",
"telephone_number": "508-865-0262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-334-3271",
"fax_number": "508-856-5911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "MARTHA",
"middle_name": "LAROSE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-12",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MA",
"license": "RN115845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARTHA",
"last_name": "LAROSESAMPSON",
"credential": "CR NA",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.