NPIMap

Individual provider Active NPI

Stephanie Vampola-Runyan, D.O.

  • Family Medicine Physician
  • Audubon, IA
National Provider Identifier
1891101457
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-10154 Issued in IA
Practice address
515 Pacific Ave
Audubon, IA 50025-1056
Phone
(712) 563-4611
Fax
(563) 742-4355
NPI assigned
Jul 3, 2014
Last updated
Mar 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-10154 IA Primary

Addresses

Primary practice location

515 Pacific Ave
Audubon, IA 50025-1056

Mailing address

515 Pacific Ave
Audubon, IA 50025-1056
Phone (712) 563-4611

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
I20160527001486 IA Practitioner - Family Practice 1658596341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audubon County Memorial HospitalGroup PAC ID 7618866096, shared by 5 NPIs, 15 clinicians

Practice addresses (Care Compare)

515 Pacific Ave
Audubon, IA 50025-1056
Phone (712) 563-2611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.09 of 100Reported as group
Quality
92.17
Promoting interoperability
88
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Audubon County Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
Audubon County Memorial Hospital CurrentSince Jul 1, 2017 Accepting new patients
Trinity Medical Center Family Medicine Past Accepting new patients

Locations

515 Pacific Ave
Audubon, IA 50025
Phone (712) 563-2611

Interoperability endpoints

  • Direct secure messaging: svampolarunyan223523@uihcdirect.org

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
Exira Care CenterExira, IA, CCN 165412 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 5, 1988
Sep 15, 2025

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 3

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 10

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": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1891101457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PACIFIC AVE",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251056",
            "telephone_number": "712-563-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PACIFIC AVE",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251056",
            "telephone_number": "712-563-4611",
            "fax_number": "563-742-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAMPOLA-RUNYAN",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-10154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, IA

Sources for this page

Verify at the official NPI Registry.