Samuel Joseph Cross-Sarvis, PMHNP-BC, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201707205NP-PP Issued in OR

Practice address

5263 NE Martin Luther King Jr Blvd
Portland, OR 97211-3235

Phone

(503) 217-4455

NPI assigned

Feb 25, 2011

Last updated

Jul 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Compass Health

  • Community/Behavioral Health Agency
  • Everett, WA
  • NPI 1730136201
  Medicare reassignment NPD
• Sarvis Mental Health Inc

  dba Synchronous Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Oswego, OR
  • NPI 1790495802
  NPD Authorized official
• Kessler Family Health LLC

  • Family Nurse Practitioner
  • Clear Spring, MD
  • NPI 1871351890
  NPD

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1922305978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5263 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113235",
            "telephone_number": "503-217-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5263 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113235",
            "telephone_number": "503-217-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Avenue B",
            "address_purpose": "LOCATION",
            "city": "Snohomish",
            "state": "WA",
            "postal_code": "982902840",
            "country_code": "US",
            "telephone_number": "425-349-7244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSS-SARVIS",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-25",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00176573",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003416",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "60621382",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201707205NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Crose, CADC I
• Aurora Rosa Crosetti, RN
• Brian Adam Crosland, M.D., M.P.H.
• Alexandra Cross-Knorr, PHD
• Samuel Cross-Knorr, M.D.
• Ashlyn J Cross, ANP
• Emilie Cross
• Jerome Cross
• Kacy Cross
• Keith Phillip Cross, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.