The Evangelical Lutheran Good Samaritan Society

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Doing business as

Good Samaritan Society - Canton

Practice address

1022 N Dakota St
Canton, SD 57013-1004

Phone

(605) 987-2696

Fax

(605) 987-4198

NPI assigned

Aug 13, 2018

Last updated

Aug 13, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

George Grant Tribble

Title

Executive VP

Phone

(605) 362-3900

Specialties & licenses 1

Addresses

Other names 1

• Good Samaritan Society - Canton Doing business as

Part of

Good Samaritan Home

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534118400000",
    "number": "1093294787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 N DAKOTA ST",
            "city": "CANTON",
            "state": "SD",
            "postal_code": "570131004",
            "telephone_number": "605-987-2696",
            "fax_number": "605-987-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A",
        "authorized_official_last_name": "TRIBBLE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "605-362-3900"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society - Canton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Dakota Dental Associates PLLC
• Dane Steffen, DDS
• Dani Jo Suess
• Chanesse Swanson, PA-C
• Michael R Swenson, DC
• The Evangelical Lutheran Good Samaritan Society (Canton Good Samaritan Center)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Canton)
• Tieszen Chiropractic Clinic, P.C.
• Chad Lane Tieszen, DC
• Jonathan Toso, O.D.

• Nurse Practitioner in Canton, SD
• Providers in Canton, SD by specialty
• Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.