Tommy Wayne Sampson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2016033441 Issued in MO

Practice address

500 N Nappanee St
Suite 11B
Elkhart, IN 46514-1503

Phone

(574) 522-9922

Fax

(574) 522-9926

NPI assigned

Sep 6, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Anesthesia Providers SCGroup PAC ID 9830480581, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkland Health Center Hospital, Farmington, MO, CCN 260163

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Midwest Anesthesia Providers S.C

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1295189082

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

• Parkland Health Center

  • General Acute Care Hospital
  • Farmington, MO
  • NPI 1003824061
  Care Compare affiliation
• Parkland Health Center

  • Psychiatric Hospital Unit
  • Farmington, MO
  • NPI 1902814866
  Care Compare affiliation

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1730514993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N NAPPANEE ST",
            "address_2": "SUITE 11B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141503",
            "telephone_number": "574-522-9922",
            "fax_number": "574-522-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N NAPPANEE ST",
            "address_2": "SUITE 11B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141503",
            "telephone_number": "574-522-9922",
            "fax_number": "574-522-9926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 W Liberty St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401921",
            "country_code": "US",
            "telephone_number": "573-760-8002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "TOMMY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101222",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2016033441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1101 W Liberty St",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636401921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julia Ilene Salamone, NP
• Maria Salazar
• Gregory Philip Salmon, RSA
• Megan Salyer, MSN, RN, FNP-BC
• Natavia Sample
• Alondra Sanchez Andrade
• Shannon Sanchez-Martinez
• Danielle Sanders
• Kiara Sanders
• Maria Sanders

• Certified Registered Nurse Anesthetist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.