LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER (NPI# 1336162874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336162874 |
| Entity Type | Organization |
| Organization Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
1015 Nw 22nd Ave Portland OR 97210-3025 |
| Mailing Address |
Po Box 4037 Portland OR 97208-4037 |
| Practice Telephone | 5034134848 |
| Mailing Telephone | 5034134048 |
| Mailing Fax Number | 5034134449 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | SARAH JENSEN (INTERIM CFO) |
| Authorized Official Telephone | 5034155145 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 14-0027 | OR | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2010683 | 05 | |
| OR | 077404 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1780608216 | Legacy Good Samaritan Hospital and Medical Center | Transplant Surgery | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2006-07-27 |
| 1679597108 | Legacy Good Samaritan Hospital and Medical Center | Psychiatry & Neurology | 1200 Nw 23rd Ave, Portland, OR 97210-2906 | 2006-07-27 |
| 1942223482 | Legacy Good Samaritan Hospital and Medical Center | Rehabilitation Unit | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2006-07-25 |
| 1609896174 | Legacy Good Samaritan Hospital and Medical Center | Pharmacy | 1040 Nw 22nd Ave, Suite 100, Portland, OR 97210-3057 | 2006-07-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 1015 Nw 22nd Ave, Portland, OR 97210 |
| Washington State Corporations | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 1015 Nw 22nd Ave, Portland, OR 97210-3025 |
| Street Address |
1015 NW 22ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467449629 | Chen-wen Christopher Heh | Psychiatry & Neurology | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2005-10-03 |
| 1023620770 | Jenelle Lynn Stinson | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-08-22 |
| 1821618935 | Jena Jobin | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-04-17 |
| 1164041810 | Danielle Amelie Parker | Occupational Therapist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-04-13 |
| 1659910362 | Ellen Lee | Nurse Anesthetist, Certified Registered | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-12-27 |
| 1487291787 | Nicholai Leon Mathewson | Nurse Anesthetist, Certified Registered | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-12-05 |
| 1528603438 | Lap Huy Nguyen | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-14 |
| 1649814617 | Ethan Andrew Blashford | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-03 |
| 1770127854 | Meri Leah Grotzinger | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-01 |
| 1467095307 | Dennis Thompson | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821517533 | Indiana University Health Jay, Inc. | Psychiatric Unit | 500 W Votaw St, Portland, IN 47371-1322 | 2017-09-13 |
| 1245773225 | Legacy Emanuel Hospital & Health Center | Psychiatric Unit | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2016-11-23 |
| 1164811972 | Providence Health & Services Oregon | Psychiatric Unit | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2015-01-16 |
| 1023194271 | Providence Health & Services - Oregon | Psychiatric Unit | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2006-10-31 |
| 1164507695 | Portland Veterans Affairs Medical Center | Psychiatric Unit | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2006-10-25 |
| 1003822487 | Legacy Emanuel Hospital & Health Center | Psychiatric Unit | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2006-07-31 |
| 1811917222 | Mainehealth | Psychiatric Unit | 22 Bramhall St, Portland, ME 04102 | 2006-07-20 |
| 1275506024 | Jay County Hospital | Psychiatric Unit | 500 W Votaw St, Portland, IN 47371-1322 | 2006-02-10 |
| 1033191309 | Portland Adventist Medical Center | Psychiatric Unit | 10123 Se Market St, Portland, OR 97216-2532 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790904225 | Good Samaritan Hospital Corvallis | Psychiatric Unit | 3509 Nw Samaritan Drive Suite 100, Corvallis, OR 97330-3766 | 2007-04-24 |
| 1659751360 | Providence Health & Services Oregon | Psychiatric Unit | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2015-06-08 |
| 1699019216 | Willamette Valley Medical Center LLC | Psychiatric Unit | 2700 Se Stratus Ave, Mcminnville, OR 97128-6255 | 2012-11-20 |
| 1760612519 | Samaritan Health Services | Psychiatric Unit | 3509 Nw Samaritan Dr, Corvallis, OR 97330-3766 | 2009-07-14 |
| 1811038367 | Mercy Medical Center, Inc. | Psychiatric Unit | 2700 Nw Stewart Pkwy, Roseburg, OR 97470-1281 | 2007-02-09 |
| 1114002128 | Asante | Psychiatric Unit | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-10-26 |
| 1457454928 | Peacehealth | Psychiatric Unit | 1255 Hilyard St, Eugene, OR 97401-3718 | 2006-09-07 |
| 1518983659 | Department of Veterans Affairs | Psychiatric Unit | 913 Nw Garden Valley Blvd, Mhs - Ward 3u Sipu, Roseburg, OR 97470-6523 | 2006-07-14 |
| 1083645428 | Mercy Medical Center, Inc. | Psychiatric Unit | 2700 Nw Stewart Pkwy, Roseburg, OR 97470-1281 | 2006-07-05 |
| 1962453134 | Good Samaritan Hospital Corvallis | Psychiatric Unit | 3600 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2006-05-13 |
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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.