Good Samaritan Hospital
Organization Active NPI Rural Health Clinic/Center · Vincennes, IN
NPI 1154084358 · NPPES record last updated Apr 14, 2026
Key facts
- NPI
- 1154084358
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- GOOD SAMARITAN HOSPITAL
- Practice address
- 406 N 1St St Ste C
Vincennes, IN 47591-1358 - Phone
- (812) 882-1106
- Fax
- (812) 885-2758
- NPI assigned
- Oct 15, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- GOOD SAMARITAN HOSPITAL
Authorized official
- Name
- Adam Thacker
- Title
- Ceo
- Phone
- (812) 882-5220
Owned or controlled facilities with NPI records 18
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 37
Related certifications (CCN) 2
Practitioners 12
-
Michael L Cantwell, M.D.
-
Eleni Guoli, LMHC
-
Kristi L Harper, LCSW
-
Silpa Kamisetti, M.D.
-
Emily A Kramer, LCSW
-
Allie E Thomas-Fannin, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Rural health clinic certification: CCN 158577
- Legal name
- GOOD SAMARITAN HOSPITAL
- Doing business as
- GOOD SAMARITAN FAMILY PRACTICE 120
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 27, 2023
- Last certification
- Dec 27, 2023
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Incorporated
- Apr 1, 1903 in IN
- Enrollment address
- 406 N 1St St
Ste C
Vincennes, IN 47591-1358 - Related CCNs
- 150042
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Matthew Schuckman |
Corporate Officer |
Jan 1, 2023 | |
| Carolyn Gordon |
W-2 Managing Employee |
Jan 1, 2023 | |
| Stanley Dewesse |
Corporate Director |
Jan 1, 2023 | |
| Mary C Martin |
Corporate Director |
Jan 1, 2023 | |
| Robert D McLin |
Corporate Officer |
Jan 1, 2023 | |
| Billie Hawkins |
W-2 Managing Employee |
Jan 1, 2023 | |
| Susan Brocksmith |
Corporate Director |
Jan 1, 2023 |
All facility ownership & control disclosures 17
| Facility | Type | Role | Since |
|---|---|---|---|
| Good Samaritan Hospital |
Hospital | Other | Apr 5, 2015 |
| Amber Manor Care Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
May 1, 2015 May 1, 2015 Jul 31, 2025 |
| St Charles Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| West River Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| River Pointe Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| Oakwood Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| Woodmont Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| Riveroaks Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| Scenic Hills at the Monastery |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| Bridgepointe Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
May 1, 2015 May 1, 2015 Jun 23, 2025 |
| Terrace at Solarbron the |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2016 |
| North River Health Campus |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 1, 2015 May 1, 2015 |
| Good Samaritan Home Care Services of Vincennes in, LLC |
Home health agency | 5% Or Greater Direct Ownership Interest (50%) | Dec 1, 2004 |
| Good Samaritan Home Care Services |
Home health agency | 5% Or Greater Direct Ownership Interest (50%) | Mar 1, 2018 |
| Good Samaritan Hospital Physician Services, Inc |
Rural health clinic | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2011 |
| Good Samaritan Internal Medicine 100 |
Rural health clinic | Operational/Managerial Control Other |
Jan 1, 2023 Jan 1, 2023 |
| Good Samaritan Washington Primary Care |
Rural health clinic | Operational/Managerial Control (100%) Other |
Jun 1, 2025 Jun 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230802002388 | IN | Part a Provider - Rural Health Clinic | 9436061918 | Practice locations: Vincennes, IN |
National Provider Directory
- Tax ID family
- Good Samaritan Hosp
- Part of
- Good Samaritan Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
406 N 1St St Ste C
Vincennes, IN 47591-1358
Mailing address
1160 E Saint Clair St
Vincennes, IN 47591-4853
Phone (812) 885-3325
Other names
- Good Samaritan Family Practice 120
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.datavant.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service | Other | Ciox Health |
Other providers in Vincennes, IN
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
- Good Samaritan Hospital
All providers in Vincennes, IN · Rural Health Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.