GOOD SAMARITAN PHYSICIAN SERVICES (NPI# 1316076961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316076961 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN PHYSICIAN SERVICES |
| Other Organization Name | WELLSPAN FAMILY MEDICINE - NORTH FOURTH STREET |
| Practice Address |
30 N 4th St 2nd Floor Lebanon PA 17046-5606 |
| Mailing Address |
Po Box 300 Lebanon PA 17042-0300 |
| Practice Telephone | 7172740474 |
| Practice Fax Number | 7172740673 |
| Mailing Telephone | 7172707780 |
| Mailing Fax Number | 7172749746 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2016-10-04 |
| Authorized Official Name | JODY M BOGER (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7172707780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 001864024 | 05 |
| Other Name | Type Code |
|---|---|
| WellSpan Family Medicine - North Fourth Street | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316301724 | Good Samaritan Physician Services | Radiology | 844 Tuck Street, Lebanon, PA 17042 | 2016-04-12 |
| 1497021018 | Good Samaritan Physician Services | Internal Medicine | 761 Norman Drive, Lebanon, PA 17042-7497 | 2012-03-28 |
| 1326064460 | Good Samaritan Physician Services | Emergency Medicine | 4th and Willow Streets, Lebanon, PA 17042-0300 | 2006-07-14 |
| 1063963585 | Good Samaritan Physician Services | Surgery | 4th and Walnut Streets, 2ns Floor, Lebanon, PA 17042 | 2016-10-19 |
| 1558749846 | Good Samaritan Physician Services | Urology | 735 Norman Dr, Suite B, Lebanon, PA 17042-7497 | 2015-05-07 |
| 1821429994 | Good Samaritan Physician Services | Family Medicine | 101 Fairview Cir, Lebanon, PA 17042-9581 | 2013-11-27 |
| 1346672086 | Good Samaritan Physician Services | Physician Assistant | 4th & Walnut Street, Lebanon, PA 17042 | 2013-08-05 |
| 1598007783 | Good Samaritan Physician Services | Emergency Medicine | 840 Tuck St, Lebanon, PA 17042-7477 | 2013-03-26 |
| 1861752073 | Good Samaritan Physician Services | Social Worker | 30 N 4th St, 4th and Willow Streets, Lebanon, PA 17046-4808 | 2012-05-22 |
| 1427376797 | Good Samaritan Physician Services | Hospitalist | 4th and Walnut Streets, 3rd Floor, Lebanon, PA 17042-0300 | 2010-05-12 |
| Street Address |
30 N 4TH ST 2ND FLOOR |
| City | LEBANON |
| State | PA |
| Zip Code | 17046-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275513814 | Jane Zendarski | Acupuncturist | 30 N 4th St, Lebanon, PA 17046-5606 | 2006-01-19 |
| 1174133433 | Mobeena Arif | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-08-03 |
| 1619594462 | Marta Halytska | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-06-28 |
| 1528682887 | Francis Guerra-bauman | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-06-02 |
| 1447872189 | Asna Tasleem | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-05-16 |
| 1053933879 | Muhammad Ali Chaudhary | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-05-14 |
| 1043831563 | Sobia Zareen | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-05-06 |
| 1063033223 | Anila Gidwani | Physical Therapist | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-04-29 |
| 1154982221 | Trajan Barrera | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2019-06-27 |
| 1750942900 | Derek J Baughman | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2019-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568708972 | Amy Lesher | Counselor | 200 N &th Street, Lebanon, PA 17046 | 2012-12-13 |
| 1053656033 | Jessica L Hoffman | Nutritionist | 4053 Church Hill Road, Lebanon, PA 17046 | 2012-12-03 |
| 1568772135 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 400 Narrows Drive, Lebanon, PA 17046 | 2010-10-18 |
| 1336213024 | William Lee Huffman | Optometrist | 40 N 8th St, Lebanon, PA 17046 | 2006-11-17 |
| 1366534620 | Pennsylvania Counseling Services Inc | Counselor | 200 N 7th St., Lebanon, PA 17046 | 2006-09-28 |
| 1922106541 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 833 Bowman St The Promenade At Lebanon E, Lebanon, PA 17046 | 2006-09-20 |
| 1457360471 | Lebanon Oncology & Hematology Assoc. | Internal Medicine | 4th & Willow St, Hyman S Caplan Pavilion, Lebanon, PA 17046 | 2006-08-07 |
| 1942218987 | Craig M Wilson | Chiropractor | 624 N Ninth Street, Family Care Chiropractic, Lebanon, PA 17046 | 2006-08-04 |
| 1477575975 | John I Shearer | Counselor | 1560 Jody Ave, Lebanon, PA 17046 | 2006-07-24 |
| 1316921950 | Deborah J Thomas | Counselor | 408 N 15th Ave, Lebanon, PA 17046 | 2005-12-06 |
| Find all providers in zip 17046 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134604606 | Stayton Family Practice Inc | Family Medicine | 41 E Ash St, Lebanon, OR 97355-3317 | 2018-10-01 |
| 1033693031 | Heather Heck | Family Medicine | 1701 Cornwal Road, Lebanon, PA 17042-7480 | 2018-09-17 |
| 1982113148 | A1 Health Care Clinic | Family Medicine | 703 East Main Street, # 8, Lebanon, KY 40444 | 2017-09-20 |
| 1952830127 | Juliana Zamora Cubillos | Family Medicine | 120 Hospital Dr Ste 100, Lebanon, MO 65536-9227 | 2017-06-09 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1982080255 | Dawn Barker | Family Medicine | 331 Hospital Dr Ste C, Lebanon, MO 65536 | 2015-08-10 |
| 1467848952 | Kelly Renee Deatley | Family Medicine | 325 W Walnut St Ste 600, Lebanon, KY 40033 | 2015-04-10 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1407288210 | Healthsource of Ohio, Inc. | Family Medicine | 1231 Columbus Ave, Unit A 1, Lebanon, OH 45036-8195 | 2013-08-02 |
| 1598108763 | Docare,llc | Family Medicine | 680 E Grant St, Lebanon, OR 97355-4432 | 2013-04-08 |
| Find all providers in LEBANON | ||||
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| 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.