NPIMap

Individual provider Active NPI

Samantha Keady, D.O.

  • Family Medicine Physician
  • Knoxville, IA
National Provider Identifier
1649623711
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-05050 Issued in IA
Practice address
1002 S Lincoln St
Knoxville, IA 50138-3121
Phone
(641) 842-2151
NPI assigned
Jul 13, 2016
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-10751 IA
Family Medicine Physician 207Q00000X DO-05050 IA Primary

Addresses

Primary practice location

1002 S Lincoln St
Knoxville, IA 50138-3121

Mailing address

1002 S Lincoln St
Knoxville, IA 50138-3121
Phone (641) 485-6388

Other practice location 1

840 E University Ave
Des Moines, IA 50316-2304
Phone (515) 265-4211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004000106 IA Practitioner - Family Practice 4688969330 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Community Hospital IncGroup PAC ID 6608787056, shared by 3 NPIs, 34 clinicians

Practice addresses (Care Compare)

1002 S Lincoln St
Knoxville, IA 50138-3151
Phone (641) 842-2151

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-10751IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pocahontas Community Hospital Current Accepting new patients
Knoxville Community Hospital Inc Family Medicine CurrentSince Feb 15, 2019 Accepting new patients
Pocahontas Community Hospital CurrentSince Dec 30, 2017 Accepting new patients
Knoxville Community Hospital Inc CurrentSince Feb 15, 2019 Accepting new patients
Knoxville Community Hospital Inc Current Accepting new patients

Locations

300 Sioux Valley Dr
Cherokee, IA 51012
Phone (712) 225-3368

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

606 NW 7th St
Pocahontas, IA 50574
Phone (712) 335-3501

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Knoxville Hospital & ClinicsKnoxville, IA, CCN 161355 Hospital W-2 Managing Employee Jan 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1649623711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 S LINCOLN ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383121",
            "telephone_number": "641-485-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 S LINCOLN ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383121",
            "telephone_number": "641-842-2151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 E University Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503162304",
            "country_code": "US",
            "telephone_number": "515-265-4211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEADY",
        "first_name": "SAMANTHA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-10751",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, IA

Sources for this page

Verify at the official NPI Registry.