THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1841280476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841280476 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - DAVENPORT |
| Practice Address |
700 Waverly Rd Davenport IA 52804-4317 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 5633241651 |
| Practice Fax Number | 5633363963 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2012-12-28 |
| 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 | 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 |
|---|---|---|---|
| IA | BLUE CROSS BLUE SHIELD | 65169 | 01 |
| IA | 0801423 | 05 | |
| IA | MIDLANDS CHOICE | F248086 | 01 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Davenport | 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 |
700 WAVERLY RD |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52804-4317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063872687 | Sandra Jean Hall | Occupational Therapy Assistant | 700 Waverly Rd, Davenport, IA 52804-4317 | 2016-02-24 |
| 1902261803 | Amanda Markovich | Occupational Therapist | 700 Waverly Rd, Davenport, IA 52804-4317 | 2015-12-18 |
| 1720415920 | Christina Ralston | Occupational Therapist | 700 Waverly Rd, Davenport, IA 52804-4317 | 2013-10-02 |
| 1902233455 | Sarah Michelle Gasser | Physical Therapy Assistant | 700 Waverly Rd, Davenport, IA 52804-4317 | 2013-09-30 |
| 1265869713 | Holle Ahna Maricle | Speech-Language Pathologist | 700 Waverly Rd, Davenport, IA 52804-4317 | 2013-09-30 |
| 1730516485 | Deanna L Axtell | Physical Therapy Assistant | 700 Waverly Rd, Davenport, IA 52804-4317 | 2013-09-26 |
| 1033546783 | Cresencia Jene Burhans | Occupational Therapist | 700 Waverly Rd, Davenport, IA 52804-4317 | 2013-09-26 |
| 1740617406 | Lisa Marie Garlock | Physical Therapy Assistant | 700 Waverly Rd, Davenport, IA 52804-4317 | 2013-09-26 |
| 1407091234 | Erika Lynn Adamson | Occupational Therapy Assistant | 700 Waverly Rd, Davenport, IA 52804-4317 | 2008-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265948467 | Tess Nelson | Physical Medicine & Rehabilitation | 2535 Maplecrest Rd Suite 23, Bettendorf, IA 52804 | 2017-12-26 |
| 1124494380 | Erica Lauren Hempel Bucy | Social Worker | 1333 W. Lombard St. Ste C, Davenport, IA 52804 | 2015-08-11 |
| 1477859890 | Kristin L West | Registered Nurse | 1441 W. Centrral Park Ave, Vera French Community Mental Health Center, Davenport, IA 52804 | 2011-02-02 |
| 1679877625 | Linda Marie Crownover-inch | Doula | 1420 W 16th Street, #412, Davenport, IA 52804 | 2011-01-05 |
| 1124169032 | Lawrence R Huber | Dentist | 2305 Jersey Ridge Rd, Davenport, IA 52804 | 2007-02-12 |
| 1669532388 | Providence Therapy Services LLC | Physical Therapist | 21037 Holden Drive, Davenport, IA 52804 | 2006-12-11 |
| 1639183171 | Megan Denise Long | Occupational Therapist | 31037 Holden Dr, Davenport, IA 52804 | 2006-07-28 |
| 1811919772 | Theresa L Schlabach | Occupational Therapist | 21037 Holden Dr, Davenport, IA 52804 | 2006-07-23 |
| 1225097843 | William M Nissen | Psychiatry & Neurology | 1441 W Central Park, Davenport, IA 52804 | 2006-03-22 |
| 1245721851 | Mackenzie J Banwart | Physical Therapist | 1700 N Division St Ste 200, Davenport, IA 52804 | 2018-05-21 |
| Find all providers in zip 52804 | ||||
| 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 |
|---|---|---|---|---|
| 1932362431 | Manorcare Health Services LLC | Skilled Nursing Facility | 3800 Commerce Blvd, Davenport, IA 52807-3495 | 2008-07-03 |
| 1730259813 | Lutheran Home for The Aged Association-east | Skilled Nursing Facility | 1130 W 53rd St, Davenport, IA 52806-2401 | 2006-11-08 |
| 1093819211 | Lincoln County Hospital District #3 | Skilled Nursing Facility | 10 Nichols St, Davenport, WA 99122-9729 | 2006-09-08 |
| 1871501486 | 206 Management LLC | Skilled Nursing Facility | 206 W Orange St, Davenport, FL 33837-3118 | 2006-08-03 |
| 1811922826 | Fejervary Health Care Center | Skilled Nursing Facility | 800 E Rusholme St, Davenport, IA 52803-2547 | 2006-07-11 |
| 1760420798 | Manor Care of Davenport Ia LLC | Skilled Nursing Facility | 815 E Locust St, Davenport, IA 52803-4345 | 2006-06-03 |
| 1962468769 | Petersen Health Care, Inc. | Skilled Nursing Facility | 4656 W Kimberly Rd, Davenport, IA 52806-7111 | 2006-04-21 |
| 1013910553 | Kahl Home for The Aged & Infirm | Skilled Nursing Facility | 6701 Jersey Ridge Road, Davenport, IA 52807 | 2005-05-28 |
| 1639615271 | Accordius Health At St Mary, LLC | Skilled Nursing Facility | 800 E Rusholme St, Davenport, IA 52803-2547 | 2017-01-06 |
| 1619427689 | Rusholme Healthcare, Inc. | Skilled Nursing Facility | 800 E Rusholme St, Davenport, IA 52803-2547 | 2016-10-13 |
| Find all providers in DAVENPORT | ||||
Please comment or provide details below to improve the information on THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY.
| 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.