NPI 1164399085

Kip Sampson, CMCPSSCBRS

Practitioner Case Manager/Care Coordinator Meridian, ID

Practice location

Address: 3288 E Pine Ave, Meridian, ID 83642-5922
Phone: (208) 888-8887

Registered specialties (3)

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

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Peer Specialist

Other Service Providers Taxonomy 175T00000X

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Rehabilitation Practitioner

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225400000X

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Registry record

NPI: 1164399085
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Oct 2025
Record last updated: 23 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.