Samantha J Jirak, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A136122 Issued in IA

Practice address

504 N 9TH Ave
Vinton, IA 52349-2254

Phone

(319) 472-6300

NPI assigned

Oct 4, 2018

Last updated

Dec 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Jo Ferguson Former name

Electronic endpoints 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Gay Hospital IncGroup PAC ID 1759290331, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjirak687210@direct.unitypoint.org

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

• Virginia Gay Hospital, Inc

  • Critical Access Hospital
  • Vinton, IA
  • NPI 1164486726
  Medicare reassignment Care Compare group NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Virginia Gay Hospital, Inc

  dba Vinton Family Medical Clinic

  • Rural Health Clinic/Center
  • Vinton, IA
  • NPI 1447293063
  NPD
• Virginia Gay Hospital Inc.

  dba Virginia Gay Hospital Home Health Agency

  • Home Health Agency
  • Vinton, IA
  • NPI 1104827732
  NPD (past)

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1619442803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N 9TH AVE",
            "city": "VINTON",
            "state": "IA",
            "postal_code": "523492254",
            "telephone_number": "319-472-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N 9TH AVE",
            "city": "VINTON",
            "state": "IA",
            "postal_code": "523492254",
            "telephone_number": "319-472-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIRAK",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A136122",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G136122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjirak@vghinc.com",
            "affiliation": "N",
            "endpointDescription": "Vinton Family Medical  Clinic Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "504 N 9th Ave",
            "city": "Vinton",
            "state": "IA",
            "country_code": "US",
            "postal_code": "523492254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "FERGUSON",
            "middle_name": "JO",
            "credential": "DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Iowa Host Homes (Eastern Iowa Host Homes)
• Iowa Physicians Clinic Medical Foundation (Vinton Family Practice)
• Samantha Isaac, PA
• Leah Isaacson, SLP-CF
• Katie C Iverson, PA
• Lagrange Pharmacy Inc
• Lagrange Pharmacy Inc.
• Alison Lagrange, ARNP
• Robert Michael Lagrange, RPH
• Gene R Lariviere, M.D.

• Family Nurse Practitioner in Vinton, IA
• Providers in Vinton, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.
• 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.