NPIMap

Organization Active NPI

Sampson Family Therapy Services LLC

  • Marriage & Family Therapist
  • Des Moines, IA
National Provider Identifier
1619377595
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000320 Issued in IA
Legal business name
SAMPSON FAMILY THERAPY SERVICES LLC
Practice address
309 Court Ave
Suite 241
Des Moines, IA 50309-2245
Phone
(515) 875-4816
Fax
(515) 875-4817
NPI assigned
Aug 28, 2014
Last updated
Aug 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Amber Sampson, M.S.NPI 1407169105
Title
Owner
Phone
(319) 290-1659

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 000320 IA Primary

Addresses

Primary practice location

309 Court Ave
Suite 241
Des Moines, IA 50309-2245

Mailing address

309 Court Ave
Suite 241
Des Moines, IA 50309-2245
Phone (515) 875-4816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210902002270 IA Part B Supplier - Clinic/Group Practice 6800292640 Receives reassigned benefits from 18 practitioners
Practice locations: Des Moines, IA

National Provider Directory

National Provider Directory

Locations

309 Court Ave
Ste 241
Des Moines, IA 50309
Phone (515) 875-4816

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1619377595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 COURT AVE",
            "address_2": "SUITE 241",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092245",
            "telephone_number": "515-875-4816",
            "fax_number": "515-875-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 COURT AVE",
            "address_2": "SUITE 241",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092245",
            "telephone_number": "515-875-4816",
            "fax_number": "515-875-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPSON FAMILY THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-290-1659",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "000320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.