GOOD SAMARITAN REGIONAL HEALTH CENTER (NPI# 1134457955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134457955 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN REGIONAL HEALTH CENTER |
| Other Organization Name | GOOD SAMARITAN HOSPITALIST PROVIDERS |
| Practice Address |
1 Good Samaritan Way Mount Vernon IL 62864-2402 |
| Mailing Address |
211 S Lincoln Blvd Centralia IL 62801-3655 |
| Practice Telephone | 6188994600 |
| Mailing Telephone | 6184366057 |
| Mailing Fax Number | 6185329365 |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2013-01-20 |
| Authorized Official Name | MR. DEE EVISCHI (VP FINANCIAL SERVICES) |
| Authorized Official Telephone | 6188991040 |
| Is Organization Subpart | Y |
| Parent Organization Name | GOOD SAMARITAN REGIONAL HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Good Samaritan Hospitalist Providers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194269597 | Good Samaritan Regional Health Center | Anesthesiology | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-12-05 |
| 1316282163 | Good Samaritan Regional Health Center | Pharmacy | 2 Good Samaritan Way, Suite 120, Mount Vernon, IL 62864-2475 | 2012-12-05 |
| 1487758801 | Good Samaritan Regional Health Center | Physical Medicine & Rehabilitation | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2006-09-08 |
| 1609897339 | Good Samaritan Regional Health Center | Psychiatric Unit | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2006-07-21 |
| 1043270424 | Good Samaritan Regional Health Center | Rehabilitation Unit | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2006-03-28 |
| Street Address |
1 GOOD SAMARITAN WAY |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609184 | Kent S Quinn | Radiology | 1 Good Samaritan Way, Attn Radiology Dept, Mount Vernon, IL 62864-2402 | 2005-09-14 |
| 1407470206 | Brittany L Jerger | Registered Nurse | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2020-06-08 |
| 1407418619 | Annie Rae Lowery | Registered Nurse | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2019-07-08 |
| 1366951436 | Roxanna Elise Stevens | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-09-21 |
| 1871022095 | Mathavi Sahadevan | Internal Medicine | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-06-09 |
| 1326589680 | Amber Dawn Willis | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-03-19 |
| 1194269597 | Good Samaritan Regional Health Center | Anesthesiology | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-12-05 |
| 1710439112 | Nicole Michelle Boyd | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-11-01 |
| 1588115810 | Cristina Myers | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-10-21 |
| 1144771692 | Misty Dawn Wernsman | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295356459 | Kendra Celeste Williams | Specialist | 300 Hayward Ave Apt 2h, Mount Vernon, NY 10552-1729 | 2020-04-29 |
| 1912551938 | Tania Monique Marshall | Specialist | 340 Garden Ave, Mount Vernon, NY 10553-2014 | 2019-07-29 |
| 1801357090 | Camille Blackwood | Specialist | 55 Bonita Vista Rd, Mount Vernon, NY 10552-1301 | 2019-03-29 |
| 1043717325 | Rhea Elizabeth Zificsak | Specialist | 30 Fleetwood Ave Apt 1d, Mount Vernon, NY 10552-2854 | 2018-04-12 |
| 1457866477 | Angelina Jaqueline Lewis | Specialist | 58 Parkway W, Mount Vernon, NY 10552-1141 | 2017-12-13 |
| 1083126551 | Christina Storm | Specialist | 514 Gramatan Ave Apt 7a, Mount Vernon, NY 10552-3052 | 2017-10-24 |
| 1386177350 | La Sheune Cantey | Specialist | 465 E Lincoln Ave Apt 110, Mount Vernon, NY 10552-3539 | 2017-04-06 |
| 1477001550 | Daysi N. Mina | Specialist | 55 Ehrbar Ave, Apt 3d, Mount Vernon, NY 10552-2444 | 2016-09-16 |
| 1982057410 | Gina Marie Giordano | Specialist | 40 E Birch St, Apt. # 3 D, Mount Vernon, NY 10552-1838 | 2016-07-20 |
| 1013366087 | Breonne Lewis | Specialist | 99 Pennsylvania Ave, Mount Vernon, NY 10552-2419 | 2016-06-09 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.