Samantha Ann Fisher, RD, LD is a medicare enrolled "Dietitian, Registered" provider in Ponderay, Idaho. Her current practice location is
30544 Highway 200 Ste 103, Ponderay, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 946-5110.
Samantha Ann Fisher is licensed to practice in Idaho (license number D-1162) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699370064.
Healthcare Provider's Profile
Full Name | Samantha Ann Fisher |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 30544 Highway 200 Ste 103, Ponderay, Idaho |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699370064
- Provider Enumeration Date: 12/02/2020
- Last Update Date: 11/16/2021
Medicare PECOS Information:
- PECOS PAC ID: 3971956962
- Enrollment ID: I20240125003317
Medical Identifiers
Medical identifiers for Samantha Ann Fisher such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699370064 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | D-1162 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samantha Ann Fisher allows following entities to bill medicare on her behalf.
Provider Name | Nourish, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Ann Fisher is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Samantha Ann Fisher, RD, LD Po Box 1633, Sandpoint, ID 83864-0870 Ph: (208) 290-2849 | Samantha Ann Fisher, RD, LD 30544 Highway 200 Ste 103, Ponderay, ID 83852-5005 Ph: (208) 946-5110 |
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