THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1649759499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649759499 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - WAGNER |
| Practice Address |
515 W Highway 46 Wagner SD 57380 |
| Mailing Address |
4800 W 57th St Sioux Falls SD 57108-2239 |
| Practice Telephone | 6053843661 |
| Practice Fax Number | 6053843790 |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |
| Authorized Official Name | GEORGE GRANT TRIBBLE (EXECUTIVE VP) |
| Authorized Official Telephone | 6053623900 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Wagner | 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 |
| Washington State Corporations | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Sioux Falls, SD 57117 |
| Street Address |
515 W HIGHWAY 46 |
| City | WAGNER |
| State | SD |
| Zip Code | 57380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427030543 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 515 W Highway 46, Wagner, SD 57380-9372 | 2005-11-15 |
| 1538200159 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 515 W Highway 46, Wagner, SD 57380-9372 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083070593 | Carol Lee Stewart | Nurse Practitioner | 513 3rd Street Sw, Wagner, SD 57380 | 2016-01-13 |
| 1174906705 | Jerika Kirwan | Optometrist | 720 West Hwy 46, Wagner, SD 57380 | 2015-07-01 |
| 1134334766 | Drew Tyler Anderson | Chiropractor | 109 1st St Sw, Wagner, SD 57380 | 2007-05-14 |
| 1326066796 | Wagner Indian Health Service Health Center | Clinic/Center | 111 Washington Ave, Wagner, SD 57380 | 2006-07-17 |
| 1447220603 | Jay Joseph Fitzgerald | Chiropractor | 109 1st. St. Sw, Wagner, SD 57380 | 2006-01-23 |
| 1972754422 | Timothy Eric Sass | Pharmacist | 111 Washington Ave Nw, Wagner, SD 57380 | 2008-10-02 |
| 1275741878 | Patricia Ann Goulette | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-18 |
| 1073721510 | Barbara Slaba | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-18 |
| 1225246770 | Martha J Geuther | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-18 |
| 1568679447 | Tammy L Laroche | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-17 |
| Find all providers in zip 57380 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059057 | Minx Damron Fite | Nurse Practitioner | 701 S Cloudas Ave, Sioux Falls, SD 57103-2421 | 2020-09-26 |
| 1164035945 | Channing Nordin | Nurse Practitioner | 7421 W 50th St, Sioux Falls, SD 57106-7647 | 2020-08-31 |
| 1790312478 | Spencer Robert Taylor | Nurse Practitioner | 5919 S Remington Pl Ste 200, Sioux Falls, SD 57108-5143 | 2020-03-24 |
| 1033752183 | Kendra C. Storm | Nurse Practitioner | 3615 5th St Ste 107, Rapid City, SD 57701-7360 | 2019-10-22 |
| 1639678956 | Carrie Hunt | Nurse Practitioner | 1305 West 18th Street, Emergency Department, Sioux Falls, SD 57105 | 2018-02-02 |
| 1083125082 | Sarah Kirschman | Nurse Practitioner | 353 Fairmont Boulvevard, Rapid City, SD 57701 | 2017-10-17 |
| 1316456908 | Mandy L Wilde | Nurse Practitioner | 104 W Birch St, Arlington, SD 57212 | 2017-09-26 |
| 1912424243 | Lisa Yvette Henderson | Nurse Practitioner | Va Black Hills Health Care System, 113 Comanche Rd, Fort Meade, SD 57741 | 2017-08-28 |
| 1275058216 | Angela Marie Mackner | Nurse Practitioner | 201 S Lloyd St Ste W190, Aberdeen, SD 57401-4509 | 2017-08-10 |
| 1225578198 | Autumn Rae Tucker | Nurse Practitioner | 161 S, Main Street, Mission, SD 57555 | 2017-02-27 |
| 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.