Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Alix Mitro

Individual provider Registered Dietitian · NPI 1528728318

Samantha Alix Mitro is a Registered Dietitian OR Nutrition Professional in Meridian, Idaho. Qualified in 2021, 5 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

520 S Eagle Rd Ste 1223
Meridian, ID 83642-6355
Phone: (208) 706-5260
Fax: (208) 706-5855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 190 E Bannock St, Boise, ID 83712-6241 — (208) 381-2425

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence D-1336 (ID)
Registered Dietitian Taxonomy 133V00000X

Record details

NPI number1528728318
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 21, 2021
Last updated in NPPESNovember 29, 2023
Certification dateNovember 29, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Meridian