NPIMap

Organization Active NPI

Good Samaritan Home Care Services of Vincennes, in, LLC

Doing business as Good Samaritan Home Care

  • Home Health Agency
  • Lawrenceville, IL
National Provider Identifier
1154986669
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES, IN, LLC
Doing business as
Good Samaritan Home Care
Practice address
2012 Lexington Ave Ste 103
Lawrenceville, IL 62439-2092
Phone
(618) 943-4428
NPI assigned
May 9, 2019
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES, IN, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Jack Hawkins
Title
V.P. Finance & Cfo
Phone
(513) 576-8478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

2012 Lexington Ave Ste 103
Lawrenceville, IL 62439-2092

Mailing address

6281 Tri Ridge Blvd Ste 300
Loveland, OH 45140-8345
Phone (513) 576-0262

Other names 1

  • Good Samaritan Home Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191203002668 IL Part A Provider - Home Health Agency 7517921489 Practice locations: Lawrenceville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154986669. Details of each certification follow.

Home health agency certification: CCN 148377

Legal name
GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES IN, LLC
Doing business as
GOOD SAMARITAN HOME CARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 3, 2020
Last certification
Apr 3, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 26, 2004 in IN
Enrollment address
2012 Lexington Ave
Ste 103
Lawrenceville, IL 62439-2092

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Good Samaritan Home Care ServicesCCN 148377 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Apr 3, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2170561Good Samaritan Home Care SVCS of Vincennes,in2012 Lexington Ave - Ste 103, Lawrenceville, IL 62439Certificate of waiverAug 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Home Care Services of Vincennes in LLC2 organizations share this tax ID, including this one
Part of
Good Samaritan Home Care Services of Vincennes in LLC

Other organizations with this tax ID 1

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

112 E Washington St
Sullivan, IN 47882
Phone (812) 268-1588

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Adam L Thacker Individual Corporate DirectorBoard Member Jan 1, 2025
Tom Sayre Individual Corporate OfficerBoard Member Jan 1, 2025
Health at Home Holdco, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 33%
Brenda Winkler Individual Corporate OfficerBoard Member Jan 1, 2024
Rochelle Salinas Individual Corporate OfficerChariman/Board Member Jan 1, 2025
Patricia L Hedegard Individual Corporate OfficerBoard Member Jan 1, 2024
Commonspirit Health Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2018 100%
Commonspirit Health at Home, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 100%
Michelle L Moore Individual W-2 Managing EmployeeAd; Jan 1, 2025
Matthew Schuckman Individual Corporate OfficerBoard Member Nov 19, 2021
Health at Home Blocker, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 67%
Consolidated Health Services LLC Organization, Loveland, OH LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2018 100%
American Nursing Care, LLC Organization, Loveland, OH LLC 5% Or Greater Direct Ownership Interest Mar 1, 2018 50%
Jack D Hawkins Individual Corporate OfficerVP Finance & Cfo Feb 1, 2022
Corporate DirectorVP Finance & Cfo Feb 1, 2022
Good Samaritan Hospital Organization, Vincennes, IN Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 1, 2018 50%

Owners & managing parties with NPI records 27

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 27

Facilities with the same owner 67

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • American Mercy Home Care LLC
    • Home Health Agency
    • Cincinnati, OH
    • NPI 1386849008

    American Nursing Care, LLC, Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • American Nursing Care, LLC
    • Home Health Agency
    • Columbus, IN
    • NPI 1093748402

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • American Nursing Care, LLC
    • Home Health Agency
    • Zanesville, OH
    • NPI 1174517569

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • Baptist Health Deaconess Madisonville Home Care, LLC

    dba Baptist Health Deaconess Health at Home

    • Home Health Agency
    • Madisonville, KY
    • NPI 1316723836

    Commonspirit Health at Home, LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • Centura Ventures, LLC

    dba Home Health Denver

    • Home Health Agency
    • Centennial, CO
    • NPI 1174634349

    Commonspirit Health at Home, LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • Centura Ventures, LLC

    dba Home Health Bristlecone

    • Home Health Agency
    • Frisco, CO
    • NPI 1437254612

    Commonspirit Health at Home, LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • CHI National Home Care, LLC
    • Home Health Agency
    • Colorado Springs, CO
    • NPI 1225902786

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • CHI National Home Care, LLC

    dba CHI Health at Home - Lincoln

    • Community Based Hospice Care Agency
    • Lincoln, NE
    • NPI 1235475351

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • CHI National Home Care, LLC
    • Community Based Hospice Care Agency
    • Durango, CO
    • NPI 1316811870

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • CHI National Home Care, LLC
    • Home Health Agency
    • Durango, CO
    • NPI 1407720964

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • CHI National Home Care, LLC

    dba CHI Health at Home - Lincoln

    • Home Health Agency
    • Lincoln, NE
    • NPI 1427394543

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
  • CHI National Home Care, LLC

    dba CHI Health at Home - Grand Island

    • Home Health Agency
    • Grand Island, NE
    • NPI 1437495736

    Commonspirit Health at Home, LLC, Consolidated Health Services LLC, Health at Home Blocker, LLC, Health at Home Holdco, LLC

    CMS ownership
View all 67

Practitioners & affiliated clinicians

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1154986669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6281 TRI RIDGE BLVD STE 300",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451408345",
            "telephone_number": "513-576-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 LEXINGTON AVE STE 103",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624392092",
            "telephone_number": "618-943-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES, IN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES, IN, LLC",
        "enumeration_date": "2019-05-09",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "V.P. FINANCE & CFO",
        "authorized_official_telephone_number": "513-576-8478"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, IL

Sources for this page

Verify at the official NPI Registry.