Individual provider Active NPI

Samantha Jewel Jenkins

  • Licensed Practical Nurse
  • Coralville, IA
National Provider Identifier
1679438923
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P56697 Issued in IA
Practice address
2213 2ND St
Coralville, IA 52241-1205
Phone
(319) 358-2406
Fax
(319) 358-9276
NPI assigned
Dec 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P56697 IA Primary

Addresses

Primary practice location

2213 2ND St
Coralville, IA 52241-1205

Mailing address

2213 2ND St
Coralville, IA 52241-1205
Phone (319) 358-2406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P56697IAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1766016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1679438923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 2ND ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411205",
            "telephone_number": "319-358-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 2ND ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411205",
            "telephone_number": "319-358-2406",
            "fax_number": "319-358-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SAMANTHA",
        "middle_name": "JEWEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P56697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.