NPIMap

Organization Active NPI

Good Samaritan Family Health Center, Inc

Doing business as Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Loogootee, IN
National Provider Identifier
1124736715
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GOOD SAMARITAN FAMILY HEALTH CENTER, INC
Doing business as
Family Health Center
Practice address
200 S John F Kennedy Ave
Loogootee, IN 47553-1624
Phone
(812) 295-3090
Fax
(812) 295-4328
NPI assigned
Nov 11, 2022
Last updated
Sep 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
-As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Jennifer Emmons
Title
Ceo
Phone
(812) 494-7800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

200 S John F Kennedy Ave
Loogootee, IN 47553-1624

Mailing address

PO Box 556
Vincennes, IN 47591-0556
Phone (812) 494-9501

Other names 1

  • Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190219002426 IN Part B Supplier - Clinic/Group Practice 5294099321 Receives reassigned benefits from 59 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Loogootee, IN; Washington, IN; Vincennes, IN; Petersburg, IN
O20230602000443 IN Part A Provider - Federally Qualified Health Center (FQHC) 5294099321 Practice locations: Loogootee, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124736715. Details of each certification follow.

Federally qualified health center certification: CCN 151193

Legal name
GOOD SAMARITAN FAMILY HEALTH CENTER INC
Doing business as
MARTIN COUNTY FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 30, 2023
Last certification
May 30, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 25, 2017 in IN
Enrollment address
200 S John F Kennedy Ave
Loogootee, IN 47553-1624

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Inc31 organizations share this tax ID, including this one
Part of
Good Samaritan Inc

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stanley Graber Individual Corporate OfficerCfo May 17, 2023
Bridgett Bilskie Individual W-2 Managing EmployeePayor Contract Manager May 17, 2023
Jennifer Emmons Individual 5% Or Greater Direct Ownership InterestCeo May 17, 2023 100%
Libby Gartner Individual Corporate DirectorBoard Vice Chairman Oct 1, 2019
Philip Mangin Individual Corporate DirectorBoard Chairman Oct 1, 2019
Traci French Individual Corporate DirectorChief Exec Officer Is, Quality, Rev May 17, 2023

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1124736715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475910556",
            "telephone_number": "812-494-9501",
            "fax_number": "812-494-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S JOHN F KENNEDY AVE",
            "city": "LOOGOOTEE",
            "state": "IN",
            "postal_code": "475531624",
            "telephone_number": "812-295-3090",
            "fax_number": "812-295-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2022-11-11",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "EMMONS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-494-7800"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loogootee, IN

Sources for this page

Verify at the official NPI Registry.