THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1336139856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336139856 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - WAUKON |
| Practice Address |
21 E Main St Waukon IA 52172-1748 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 5635683447 |
| Practice Fax Number | 5635682459 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2012-12-27 |
| Authorized Official Name | MS. 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 |
|---|---|---|---|
| IA | BLUE CROSS BLUE SHIELD | 65240 | 01 |
| IA | MIDLANDS CHOICE | F248116 | 01 |
| IA | PROGRAM FOR FROZEN MEALS | 0278531 | 01 |
| IA | 0801589 | 05 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Waukon | 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 |
| Indiana Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Po Box 5038, 4800 West 57th Street, Sioux Falls, SD 57117-5038 |
| Oklahoma Business Registrations | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | The, 1000 W. Avenue North, Sioux Falls, SD 57104-0000 |
| Street Address |
21 E MAIN ST |
| City | WAUKON |
| State | IA |
| Zip Code | 52172-1748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839194 | Jillian Rae Volker | Speech-Language Pathologist | 21 E Main St, Waukon, IA 52172-1748 | 2020-04-09 |
| 1912115635 | The Evangelical Lutheran Good Samaritan Society | Nursing Facility/Intermediate Care Facility | 21 E Main St, Waukon, IA 52172-1748 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235468026 | Amy Christine Pfiffner | Occupational Therapy Assistant | 201 Second Street Sw, Waukon, IA 52172 | 2009-12-08 |
| 1609098185 | Worth Living Inc. | Assisted Living Facility | 209 2nd Ave Sw, Waukon, IA 52172 | 2007-05-03 |
| 1154478857 | Mosaic | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12 E Main, Suite 102, Waukon, IA 52172 | 2007-01-04 |
| 1124121710 | Linda Sue Carstens | Dentist | 18 1st Ave Nw, Waukon, IA 52172 | 2006-09-07 |
| 1659481752 | Cameron Jon Ochsner | Dentist | 22 E Main, Wankon, IA 52172 | 2006-08-30 |
| 1831144302 | Gundersen Clinic, Ltd. | Durable Medical Equipment & Medical Supplies | 120 2nd Avenue Se, Waukon, IA 52172 | 2006-05-23 |
| 1720173990 | Northeast Iowa Dental Professional Corporation | Dentist | 18 1st Ave Nw, Waukon, IA 52172 | 2006-10-04 |
| 1265472807 | Gundersen Clinic, Ltd. | Optometrist | 120 2nd Avenue Se, Waukon, IA 52172 | 2006-06-08 |
| 1639156987 | Mayo Clinic Health System - Franciscan Medical Center, Inc. | Clinic/Center | 105 East Main Street, Waukon, IA 52172 | 2005-12-28 |
| 1528058062 | David B Schwartz | Hospitalist | 40 1st St Se, Waukon, IA 52172 | 2005-10-26 |
| Find all providers in zip 52172 | ||||
| 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 |
|---|---|---|---|---|
| 1639171077 | Abcm Corporation | Skilled Nursing Facility | 960 4th St Nw, Waukon, IA 52172-1059 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647165 | Ema Rehabilitation, LLC | Skilled Nursing Facility | 1831 E Kanesville Blvd, Council Bluffs, IA 51503-4767 | 2020-10-22 |
| 1770198855 | Wellspire-bettendorf LLC | Skilled Nursing Facility | 4699 53rd Ave, Bettendorf, IA 52722 | 2020-09-15 |
| 1114547395 | Bvm-phs Senior Housing Inc | Skilled Nursing Facility | 1160 Carmel Dr, Dubuque, IA 52003-7911 | 2020-04-17 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1992354666 | Phs Council Bluffs, Inc | Skilled Nursing Facility | 16 Valley View Drive, Council Bluffs, IA 51503 | 2019-09-05 |
| 1023679057 | Bcp Union Park, LLC | Skilled Nursing Facility | 2401 E 8th St, Des Moines, IA 50316-1717 | 2019-06-20 |
| 1639637143 | Wellspire LLC | Skilled Nursing Facility | 5508 Nw 88th St, Johnston, IA 50131-3005 | 2019-03-05 |
| 1356807101 | Accura Healthcare of Aurelia LLC | Skilled Nursing Facility | 401 W 5th St, Aurelia, IA 51005-7712 | 2019-02-18 |
| 1093286395 | Ccrc of West Des Moines, LLC | Skilled Nursing Facility | 8950 Coachlight Drive, West Des Moines, IA 50266 | 2018-12-12 |
| 1255828919 | Brio of Johnston, LLC | Skilled Nursing Facility | 6901 Peckham St, Johnston, IA 50131-3143 | 2018-04-18 |
| Find all providers with the same taxonomy | ||||
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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.