Individual provider Active NPI

Imeh Sampson, D.O.

  • Family Medicine Physician
  • Newnan, GA
National Provider Identifier
1699115402
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
109630 Issued in GA
Practice address
745 Poplar Rd
Newnan, GA 30265-1618
Phone
(770) 400-2353
NPI assigned
Jun 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 283895 NY
Hospitalist Physician 208M00000X 283895 AZ
Family Medicine Physician 207Q00000X 109630 GA Primary

Addresses

Primary practice location

745 Poplar Rd
Newnan, GA 30265-1618

Mailing address

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4728

Other practice location 1

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-5067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190212002528 AZ Practitioner - Family Practice 1850688961 Reassigns benefits to 1 organization
I20251220000776 GA Practitioner - Family Practice 1850688961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

Hospital & facility affiliations

  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109630GAMDFamily Medicine Physician
283895AZMDHospitalist Physician
283895NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Piedmont Hospitalist Physicians LLC Family Medicine CurrentSince Dec 8, 2025 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Oct 28, 2018 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Oct 28, 2018 Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1699115402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 W THUNDERBIRD BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513004",
            "telephone_number": "623-832-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "770-400-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213001",
            "country_code": "US",
            "telephone_number": "585-922-5067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "IMEH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "283895",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "283895",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "109630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.