Samantha Wiemann

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2018032450 Issued in MO

Practice address

701 NW Commerce Dr Ste 102
Lees Summit, MO 64086-5883

Phone

(816) 554-3646

NPI assigned

Apr 6, 2015

Last updated

Jun 30, 2026By 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 1

Addresses

Other names 1

• Samantha Jacobson Former name

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1708

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.

• Children's Mercy-Pediatric Associates

  • Pediatrics Physician
  • Kansas City, MO
  • NPI 1598214306
  NPD (past)

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1740675735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BROADWAY BLVD STE 206",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NW COMMERCE DR STE 102",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865883",
            "telephone_number": "816-554-3646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 Broadway Blvd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641113342",
            "country_code": "US",
            "telephone_number": "816-561-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEMANN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018032450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "JACOBSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sean Whitmore
• Dane K Wicks, MD
• Amy Wieboldt, LCSW
• Tyann Wiederholt
• Janna Wiele, MSW, LCSW
• Patricia A Wike, P.T.
• Gabrielle Wilcox
• Sara H Wilhite, DMD
• Mark S Wilkes, CRNA
• Mary B Wilkinson, D.D.S.

• Pediatrics Physician in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.