Good Samaritan Mental Health Association LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

GOOD SAMARITAN MENTAL HEALTH ASSOCIATION LLC

Practice address

500 W Votaw St
Portland, IN 47371-1322

Phone

(260) 418-7036

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Samir G Ishak, MD

Title

Owner

Phone

(260) 418-7036

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Catherine A Johnston, LCSW ACSW

  • Social Worker
  • Ft Wayne, IN
  • NPI 1033202213
  NPD (past)
• Tamara J Reynolds, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1336237320
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1154536704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W VOTAW ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473711322",
            "telephone_number": "260-418-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W VOTAW ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473711322",
            "telephone_number": "260-418-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN MENTAL HEALTH ASSOCIATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "ISHAK",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-418-7036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth A Funk
• Oakland Lawrence Gaerke, D.C.
• Todd Gaerke
• Betsi Gagle
• Malcolm Christian George, D.D.S.
• Stephanie Marie Gould, PHARMD
• Leonard J Green, MD
• Laura Ann Griffith, BSN
• Mark Allen Haggenjos, D.O.
• Anne Hardesty, NP

• Psychiatry Physician in Portland, IN
• Providers in Portland, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.