Good Samaritan Supported Living, LLC

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Legal business name

GOOD SAMARITAN SUPPORTED LIVING, LLC

Practice address

616 Mawyer Dr
Columbus, OH 43085-5403

Phone

(614) 893-0579

NPI assigned

Sep 11, 2017

Organization subpart

No

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

Authorized official

Name

Maria Theresa Yebra Villanueva, RNNPI 1881926251

Title

RN Manager

Phone

(614) 893-0579

Specialties & licenses 6

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Theresa Yebra Villanueva, RN

  • General Practice Registered Nurse
  • Columbus, OH
  • NPI 1881926251
  NPD (past) Authorized official

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1124547146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 MAWYER DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "430855403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 MAWYER DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "430855403",
            "telephone_number": "614-893-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN SUPPORTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "MARIA THERESA",
        "authorized_official_middle_name": "YEBRA",
        "authorized_official_title_or_position": "RN MANAGER",
        "authorized_official_telephone_number": "614-893-0579",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "318641",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cara Janine Good, R.D., L.D.
• Erin E Good, AUD
• Gregory W. Good, O.D., PH.D.

• Attendant Care Provider in Columbus, OH
• Providers in Columbus, OH by specialty
• Attendant Care Provider in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.