NPIMap

Organization Active NPI

Good Samaritan Hospital

  • Rural Health Clinic/Center
  • Vincennes, IN
National Provider Identifier
1447654801
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GOOD SAMARITAN HOSPITAL
Practice address
429 S 6TH St
Vincennes, IN 47591-1022
Phone
(812) 885-3703
Fax
(812) 885-3707
NPI assigned
Oct 14, 2014
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Robert D McLin
Title
Ceo
Phone
(812) 885-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X IN Primary

Addresses

Primary practice location

429 S 6TH St
Vincennes, IN 47591-1022

Mailing address

429 S 6TH St
Vincennes, IN 47591-1022
Phone (812) 885-3703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000723 IN Part B Supplier - Clinic/Group Practice 9436061918 Receives reassigned benefits from 12 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vincennes, IN

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1447654801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 S 6TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911022",
            "telephone_number": "812-885-3703",
            "fax_number": "812-885-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 S 6TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911022",
            "telephone_number": "812-885-3703",
            "fax_number": "812-885-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "MCLIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-885-3333"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.