Individual provider Active NPI

Tilly Effie Duncan-Sampson, MD

  • Pediatrics Physician
  • Lima, OH
National Provider Identifier
1598775801
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.077031 Issued in OH
Practice address
4803 Kitamat TRL
Lima, OH 45805-4163
Phone
(567) 204-6962
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.077031 OH Primary

Addresses

Primary practice location

4803 Kitamat TRL
Lima, OH 45805-4163

Mailing address

4803 Kitamat TRL
Lima, OH 45805-4163
Phone (419) 224-3892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210317000666 OH Practitioner - Pediatric Medicine 9032525076 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Mar 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients

Locations

L3982
Columbus, OH 43260

525 N Eastown Rd
Lima, OH 45807
Phone (419) 228-7275

525 N Eastown Rd
Ste 102
Lima, OH 45807
Phone (419) 998-8214

1005 Bellefontaine Ave
Ste 245
Lima, OH 45804
Phone (419) 998-8230

375 N Eastown Rd
Ste C
Lima, OH 45807
Phone (419) 222-6595

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

Interoperability endpoints

  • Direct secure messaging: tilly.sampson@lmpc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1598775801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 KITAMAT TRL",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054163",
            "telephone_number": "419-224-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 KITAMAT TRL",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054163",
            "telephone_number": "567-204-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN-SAMPSON",
        "first_name": "TILLY",
        "middle_name": "EFFIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.077031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.