CMS-1500 Box 24J / 33a • NPI
1336716547
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
133V00000X (CMS 71)
Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered
Box 32 Service Location & ZIP+4
805 STEVENS AVE, PORTLAND, ME, 04103-2647
✓ 9-Digit EDI 837 ZIP+4 (04103-2647)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1336716547 (SAMANTHA BAILEY, RDN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1336716547 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SAMANTHA BAILEY, RDN |
| Plain-English Specialty | Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered NUCC Code: 133V00000X (Dietitian, Registered) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 805 STEVENS AVE, PORTLAND, ME, 04103-2647 |
| Practice Telephone / Fax | Tel: (207) 772-6279 |
| Administrative Mailing Address | 66 BIRCHWOOD RD, GRAY, ME, 04039-7761 |
| Enumeration & Last Sync | Enumerated: 2021-06-07 | CMS Record Updated: 2023-04-24 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (133V00000X)
What Does Taxonomy Code 133V00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 133V00000X translates to:
"Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SAMANTHA BAILEY, RDN)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
133N00000X — NutritionistPlain English: Licensed & Credentialed Nutritionist | State: N/A | License: Verified | Primary: Secondary |
133V00000X — Dietitian, RegisteredPlain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered | State: ME | License: DI1581 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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