Samuel P Whitmore, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

002398 Issued in IA

Practice address

3735 86TH St
Urbandale, IA 50322-4008

Phone

(515) 270-8545

Fax

(515) 270-0548

NPI assigned

Nov 12, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CVK Corporation

  • Optometrist
  • Des Moines, IA
  • NPI 1134203466

  IA, Optometrist

  Medicare reassignment NPD
• CVK Corporation

  • Optician
  • Des Moines, IA
  • NPI 1104890755
  NPD
• Eyemart Express LLC

  • Eyewear Supplier
  • Johnston, IA
  • NPI 1184419210
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1003096629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123410",
            "telephone_number": "515-279-2020",
            "fax_number": "515-255-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 86TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224008",
            "telephone_number": "515-270-8545",
            "fax_number": "515-270-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMORE",
        "first_name": "SAMUEL",
        "middle_name": "P",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique NMN Westman-Barth, PTA
• Tiffany Deette Wheeldon, LMT
• Whispering Pines Counseling, LLC
• Angela White
• Marley Grace Whitefish
• Wholesome Behavioral Health
• Hailey Wilcox, PA-C
• Penny S Williams, OD
• Karla Vaquerano Willis, LMSW
• Thomas Wills, LMSW

• Optometrist in Urbandale, IA
• Providers in Urbandale, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.