THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1659352474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659352474 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - MESA GOOD SHEPHERD |
| Practice Address |
5848 E University Dr Mesa AZ 85205-7446 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 4809810098 |
| Practice Fax Number | 4803963023 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2012-12-27 |
| Authorized Official Name | MRS. 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 | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 040452 | 05 | |
| AZ | BLUE CROSS BLUE SHIELD | AZ0073950 | 01 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Mesa Good Shepherd | 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 |
5848 E UNIVERSITY DR |
| City | MESA |
| State | AZ |
| Zip Code | 85205-7446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864986 | Goldfield Mountain Healthcare, Inc. | Clinic/Center | 5848 E University Dr, Mesa, AZ 85205-7443 | 2019-07-29 |
| 1770043630 | Goldfield Mountain Healthcare, Inc. | Assisted Living Facility | 5848 E University Dr, Mesa, AZ 85205-7443 | 2019-03-25 |
| 1326505041 | Goldfield Mountain Healthcare, Inc. | Skilled Nursing Facility | 5848 E University Dr, Mesa, AZ 85205-7443 | 2019-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130199 | Rose Campbell | Technician/Technologist | 649 North Orlando, Mesa, AZ 85205 | 2017-08-21 |
| 1528459781 | Elizabeth Sadler | Nurse Practitioner | 4434 E Brown Rd Ste 102, Mesa, AZ 85205 | 2015-02-10 |
| 1326444324 | Katherine G Perez | Counselor | 152 N Power Rd Ste 2, Mesa, AZ 85205 | 2014-11-18 |
| 1831500800 | C.b.o Hearing | Hearing Aid Equipment | 4406 E. Main St, Suite 103, Mesa, AZ 85205 | 2014-05-13 |
| 1699195107 | Amanda Mcdaniel | Occupational Therapist | 5911 E. Fountain St., Mesa, AZ 85205 | 2014-04-23 |
| 1952640278 | Medstar Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 3932 E Fairfield Cir, Mesa, AZ 85205 | 2013-02-06 |
| 1245575398 | Fabulous Smiles of Mesa | Dentist | 4434 E. Brown Rd, Ste 104, Mesa, AZ 85205 | 2012-11-30 |
| 1992087639 | Matthew Robert Millward | Pharmacist | 1935 N. Power Rd, Mesa, AZ 85205 | 2011-09-19 |
| 1740596733 | Arizona Family & Geriatric Medicine Pllc | Clinic/Center | 5602 E. Main St., Mesa, AZ 85205 | 2010-08-27 |
| 1295049609 | Thomas Chambers | Podiatrist | 5520 E Main St Ste 2, Mesa, AZ 85205 | 2010-07-28 |
| Find all providers in zip 85205 | ||||
| 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 |
|---|---|---|---|---|
| 1508249038 | Colette Eneboe | Skilled Nursing Facility | 1015 S Val Vista Dr Unit 27, Mesa, AZ 85204-5674 | 2015-07-01 |
| 1801225594 | Daniel Jayson Kronemeyer | Skilled Nursing Facility | 530 W 6th Dr, Mesa, AZ 85210-2316 | 2013-11-04 |
| 1316296122 | Rithirat John Mccollum | Skilled Nursing Facility | 255 West Brown Rd., Mesa, AZ 85201 | 2012-09-07 |
| 1407152812 | Asante of Mesa, LLC | Skilled Nursing Facility | 5358 East Baseline Road, Mesa, AZ 85206-4716 | 2011-02-02 |
| 1508037987 | Pinnacle Health Facilities Xxvi Lp | Skilled Nursing Facility | 6461 E Baywood Ave, Mesa, AZ 85206-1744 | 2008-03-13 |
| 1265543607 | Sunrise Mesa Health Care Center Inc | Skilled Nursing Facility | 3130 E Broadway Rd, Mesa, AZ 85204-1740 | 2006-08-31 |
| 1528179801 | Springdale Village, Inc. | Skilled Nursing Facility | 7255 E Broadway Rd, Mesa, AZ 85208-9201 | 2006-08-31 |
| 1295768620 | Ahc of Mesa LLC | Skilled Nursing Facility | 5755 E Main St, Mesa, AZ 85205-8814 | 2006-07-09 |
| 1528006012 | Mesa United Medical Investors Limited Partnership | Skilled Nursing Facility | 330 S Pinnule Cir, Mesa, AZ 85206-1636 | 2006-06-04 |
| 1316993793 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2006-05-26 |
| Find all providers in MESA | ||||
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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.