THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1295726669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295726669 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - MOUNTAIN HOME |
| Practice Address |
300 Good Samaritan Dr Mountain Home AR 72653-5813 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 5018843210 |
| Practice Fax Number | 5018846800 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2012-12-27 |
| Authorized Official Name | MRS. RAYE NAE NYLANDER (CFO) |
| Authorized Official Telephone | 6053623100 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS BLUE SHIELD | 15250 | 01 |
| AR | 109436311 | 05 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Mountain Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497217251 | The Evangelical Lutheran Good Samaritan Society | In Home Supportive Care | 45-090 Namoku St. Cottage H, Kaneohe, HI 96744 | 2019-04-02 |
| 1851853816 | The Evangelical Lutheran Good Samaritan Society | In Home Supportive Care | 1415 Lilac Dr N Ste 260, Golden Valley, MN 55422-4545 | 2019-04-01 |
| 1740769595 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 301 S Highway 12b, Park River, ND 58270 | 2018-08-13 |
| 1952888414 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 2765 Virginia Avenue N., New Hope, MN 55427 | 2018-07-26 |
| 1780186536 | The Evangelical Lutheran Good Samaritan Society | In Home Supportive Care | 1217 Ne Burnside Rd Ste 704, Gresham, OR 97030-5770 | 2018-03-07 |
| 1881112290 | The Evangelical Lutheran Good Samaritan Society | Skilled Nursing Facility | 4825 Jericho Way, Rapid City, SD 57702-9694 | 2017-09-06 |
| 1982154993 | The Evangelical Lutheran Good Samaritan Society | Clinic/Center | 216 Samaritan Cir, Belington, WV 26250-8141 | 2016-10-13 |
| 1659725364 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 400 S Mckinley St, Warren, MN 56762-1439 | 2016-04-19 |
| 1649640236 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 200 Good Samaritan Dr, Mountain Home, AR 72653-9325 | 2015-09-25 |
| 1760861975 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 1051 Mulberry Street, Taylors Falls, MN 55084 | 2015-05-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street,p.o. Box 5038, Sioux Falls, SD 57117-5038 |
| Oregon Corporations, Companies and Business Names | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Sioux Falls, SD 57117 |
| Iowa Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Cothe Evangelical Lutheran Good Samaritan Society, 4800 West 57th Streetp.o. Box 5038, Sioux Falls, SD 57117 |
| Ohio Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Po Box 5038, Sioux Falls, SD 57117-5038 |
| Street Address |
300 GOOD SAMARITAN DR |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-5813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265067656 | Blake Pepper | Physical Therapy Assistant | 300 Good Samaritan Dr, Mountain Home, AR 72653-5813 | 2020-03-06 |
| 1134754781 | Amanda Karen Worsham | Physical Therapy Assistant | 300 Good Samaritan Dr, Mountain Home, AR 72653-5813 | 2020-03-04 |
| 1932733045 | Janet Alvarez Alexander | Physical Therapy Assistant | 300 Good Samaritan Dr, Mountain Home, AR 72653-5813 | 2020-02-27 |
| 1073147476 | Logan Waldon | Occupational Therapy Assistant | 300 Good Samaritan Dr, Mountain Home, AR 72653-5813 | 2020-02-25 |
| 1386276293 | Sydney Desira Greene | Physical Therapist | 300 Good Samaritan Dr, Mountain Home, AR 72653-5813 | 2020-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871812099 | Pine Lane Therapy and Living Center, Inc. | Skilled Nursing Facility | 1100 Pinetree Ln, Mountain Home, AR 72653-4502 | 2010-05-27 |
| 1194822585 | Baxter County Nursing Facility, Inc. | Skilled Nursing Facility | 3545 Hwy 5 N, Mountain Home, AR 72653 | 2006-09-20 |
| 1609864537 | Cmnrc, Inc. | Skilled Nursing Facility | 804 Burnett Dr, Mountain Home, AR 72653-2939 | 2005-10-13 |
| 1538157466 | Bmnrc, Inc. | Skilled Nursing Facility | 620 Hospital Dr, Mountain Home, AR 72653-2915 | 2005-10-13 |
| 1871580076 | Kmj Enterprises Mountain Home LLC | Skilled Nursing Facility | 1100 Pine Tree Ln, Mountain Home, AR 72653-4502 | 2005-10-03 |
| 1184620791 | Elmore Medical Center Hospital District | Skilled Nursing Facility | 895 N 6th E, Mountain Home, ID 83647-2207 | 2005-06-28 |
| 1225454325 | Mhpnc, Inc. | Skilled Nursing Facility | 1100 Pinetree Ln, Mountain Home, AR 72653-4502 | 2014-03-13 |
| 1376969931 | Mhcnc, Inc. | Skilled Nursing Facility | 804 Burnett Dr, Mountain Home, AR 72653-2939 | 2014-03-06 |
| 1790101368 | Mhhnc, Inc | Skilled Nursing Facility | 620 Hospital Dr, Mountain Home, AR 72653-2915 | 2014-03-06 |
| 1508105248 | St Lukes Regional Medical Center | Skilled Nursing Facility | 895 N 6th E, Mountain Home, ID 83647-2207 | 2013-01-31 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.