ANNETTE N SAMPSON
NPI 1215241708
Nurse Practitioner - Family in Grand Ronde, OR
About Annette N Sampson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANNETTE N SAMPSON (NPI 1215241708) is an individual family provider in Grand Ronde, Oregon, licensed in Oregon (202214454NP-PP) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS, is affiliated with Willamette Valley Medical Center, and maintains a secondary practice location in Warm Springs.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Annette N Sampson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Annette Sampson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Ronde, OR 97347
- Reassigned Medicare billing, Oregon enrollment
- 27 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 10
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Willamette Valley Medical Center
Acute Care Hospitals · Mcminnville, ORWest Valley Hospital
Critical Access Hospitals · Dallas, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97347 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRAND RONDE, OR 97347
GRAND RONDE, OR 97347
GRAND RONDE, OR 97347
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Annette Sampson's NPI number?
The NPI number for Annette Sampson is 1215241708. It was assigned to this individual provider in the NPPES registry on July 27, 2010.
Where is Annette Sampson located?
Annette Sampson practices at 9605 Grand Ronde Rd, Grand Ronde, OR 97347. The listed phone number is (503) 879-2002.
What is Annette Sampson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Annette Sampson enrolled in Medicare?
Yes. Annette Sampson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Annette Sampson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Annette Sampson reassigns Medicare benefits to Confederated Tribes Of The Grand Ronde Community Of Oregon (Grand Ronde, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Annette Sampson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Annette Sampson affiliated with any hospitals?
According to CMS data, Annette Sampson is affiliated with Willamette Valley Medical Center and West Valley Hospital.
When was this NPI record last updated?
The NPPES record for Annette Sampson was last updated on July 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Annette N Sampson · NPI 1215241708
Family physician in Grand Ronde, Oregon. Individual provider, active in the CMS NPPES registry since July 27, 2010.
## Identity
- **NPI:** 1215241708 (Entity type: Individual)
- **Enumerated:** July 27, 2010
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 202214454NP-PP (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 9605 GRAND RONDE RD, Grand Ronde, OR 97347-9712
- **Phone:** (503) 879-2002 · **Fax:** (503) 879-2071
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Confederated Tribes Of The Grand Ronde Community Of Oregon (NPI 1174666358, Grand Ronde, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Oregon Health Sciences University School Of Medicine, class of 2022
## Record status
- **NPPES last updated:** July 25, 2024
- **Other identifiers:** Medicaid 171037 (OR)
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Source: [NPI Profile](https://npiprofile.com/npi/1215241708) · Data from the CMS NPPES public registry.