Individual provider Active NPI

Marilyn Sampson

  • Physician Assistant
  • Ankeny, IA
National Provider Identifier
1992275564
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3625 N Ankeny Blvd Ste F
Ankeny, IA 50023-4611
Phone
(515) 964-4600
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3625 N Ankeny Blvd Ste F
Ankeny, IA 50023-4611

Mailing address

3625 N Ankeny Blvd Ste F
Ankeny, IA 50023-4611
Phone (515) 294-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213001324 IA Practitioner - Physician Assistant 5698013852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

Hospital & facility affiliations

  • Unitypoint Health - Des Moines Iowa Methodist Medi Hospital, Des Moines, IA, CCN 160082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Nov 8, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Nov 8, 2021 Accepting new patients

Locations

3625 N Ankeny Blvd
Ste F
Ankeny, IA 50023
Phone (515) 964-4600

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4020 Merle Hay Rd
Ste 100
Des Moines, IA 50310
Phone (515) 278-0949

Interoperability endpoints

  • Direct secure messaging: mkeane602468@direct.unitypoint.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1992275564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 N ANKENY BLVD STE F",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234611",
            "telephone_number": "515-294-4600",
            "fax_number": "515-965-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 N ANKENY BLVD STE F",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234611",
            "telephone_number": "515-964-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.