Sam Willden Slade

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

CDR.0001413 Issued in CO

Practice address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Phone

(928) 757-0649

NPI assigned

Feb 9, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AZ, CO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency Medicine

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Hospital Association of the San Luis ValleyGroup PAC ID 4789589094, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008

Merit-based Incentive Payment System (MIPS)

Final score

85.41 of 100Reported as group

Quality

70.25

Promoting interoperability

100

Improvement activities

40

Cost

67.83

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Medicare reassignment Care Compare group NPD
• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  AZ

  Medicare reassignment NPD
• Gila River Health Care

  dba Thwajik Ke Outpatient Behavioral Health Services

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  dba Hu Hu Kam Memorial Hospital

  • Critical Access Hospital
  • Sacaton, AZ
  • NPI 1225023179
  NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health RMC Clinic

  • Obstetrics & Gynecology Physician
  • Alamosa, CO
  • NPI 1720269434
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1972041093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 DIAMOND SPUR ST",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864017323",
            "telephone_number": "702-300-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "SAM",
        "middle_name": "WILLDEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-09",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "007800",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "CDR.0001413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Terese Sims
• Francesco Joseph Sinopoli, D.C.
• Prashanth Sirigere Manjunath, M.D
• Krystal Danae Skinner, PMHNP
• Marvin Edgar Slack II, DO
• Sleep Better Southwest PLLC
• Slimming Grace LLC
• Jill Diane Smith-Perez
• Alicia D Smith, PTA
• Angela Irene Smith, BA

• Emergency Medicine Physician in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.