Active NPI
Samantha Stough, DO
- Pediatrics Physician
- Boise, ID
National Provider Identifier
1962933234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OC-0473
- Practice address
- 1055 N Curtis Rd
Boise, ID 83706-1309 - Phone
- (208) 302-4600
- Fax
- (208) 302-4655
- NPI assigned
- Mar 27, 2017
- Last updated
- Aug 24, 2026
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DR.0064580 | CO | |
| Pediatrics Physician | 208000000X | 58008378 | OH | |
| Pediatrics Physician | 208000000X | OC-0473 | ID | Primary |
Addresses
Primary practice location
1055 N Curtis Rd
Boise, ID 83706-1309
Mailing address
PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170
Other practice location 1
365 Dillon Ridge Rd Ste 1200
Dillon, CO 80435-6344
Phone (970) 926-6340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0064580 | CO | MD | Pediatrics Physician |
| 58008378 | OH | MD | Pediatrics Physician |
Interoperability endpoints
- sstough@yourcarecommunity.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1962933234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190930",
"city": "BOISE",
"state": "ID",
"postal_code": "837190930",
"telephone_number": "208-367-5170",
"fax_number": "208-367-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N CURTIS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837061309",
"telephone_number": "208-302-4600",
"fax_number": "208-302-4655"
}
],
"practiceLocations": [
{
"address_1": "365 Dillon Ridge Rd Ste 1200",
"address_purpose": "LOCATION",
"city": "Dillon",
"state": "CO",
"postal_code": "804356344",
"country_code": "US",
"telephone_number": "970-926-6340",
"fax_number": "970-926-6348",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOUGH",
"first_name": "SAMANTHA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-27",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "DR.0064580",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "58008378",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ID",
"license": "OC-0473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.