Good Samaritan Hospital

Primary specialty

Home Infusion AgencyTaxonomy code 251F00000X

License

IS302 Issued in WA

Legal business name

GOOD SAMARITAN HOSPITAL

Doing business as

Good Samaritan Home Health & Hospice

Practice address

1317 E Main
Puyallup, WA 98372-3136

Phone

(253) 697-7600

Fax

(253) 691-9598

NPI assigned

Aug 22, 2005

Organization subpart

No

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

Authorized official

Name

Ken McKinney, MS,RN,CHCE,CDHP

Title

Director

Phone

(253) 697-7600

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Good Samaritan Home Health & Hospice Doing business as

Locations

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417949892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1247",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710192",
            "telephone_number": "253-697-7600",
            "fax_number": "253-697-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723136",
            "telephone_number": "253-697-7600",
            "fax_number": "253-691-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "253-697-7600",
        "authorized_official_credential": "MS,RN,CHCE,CDHP"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "WA",
            "license": "IS302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS HOME HEALTH",
            "identifier": "0004",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7330079",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "1258",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "WA2923",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "0543130001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HIT",
            "identifier": "GO4586",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos Gonzalez, DPT
• Son Hui Gonzalez, MSW
• Good Night Medical of Washington, Inc.
• Good Samaritan Community Healthcare
• Good Samaritan Hospital
• Good Samaritan Outreach Services
• Good Samaritan Surgery Center LLC
• Marc William Goodboy, PA-C
• Chelsi Goodman, MD
• Jonathan Clarke Goodman, LMHC, MHP, NCC

• Home Infusion Agency in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Home Infusion Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.