Individual provider Active NPI

Samuel Farrell

  • Physical Therapist
  • Urbandale, IA
National Provider Identifier
1386532869
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13152 Issued in IA
Practice address
3033 100TH St
Urbandale, IA 50322-3882
Phone
(515) 720-8558
NPI assigned
Jun 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13152 IA Primary

Addresses

Primary practice location

3033 100TH St
Urbandale, IA 50322-3882

Mailing address

3033 100TH St
Urbandale, IA 50322-3882
Phone (515) 612-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801000214 IA Practitioner - Physical Therapist in Private Practice 7214445287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resilience Physical Therapy PLLCGroup PAC ID 7517328727, 2 clinicians

Practice addresses (Care Compare)

8033 University Blvd
Suite D
Clive, IA 50325-1170
Phone (515) 401-2086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13152IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resilience Physical Therapy PLLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients

Locations

8033 University Blvd
Ste D
Clive, IA 50325
Phone (515) 401-2086

3033 100th St
Urbandale, IA 50322
Phone (515) 612-8700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1386532869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 100TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223882",
            "telephone_number": "515-612-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 100TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223882",
            "telephone_number": "515-720-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "SAMUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "13152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.