Organization Active NPI

Samaritan Family Care Inc

Doing business as Vandalia Family Care

  • Family Medicine Physician
  • Vandalia, OH
National Provider Identifier
1467405332
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAMARITAN FAMILY CARE INC
Doing business as
Vandalia Family Care
Practice address
1 W National Rd
Vandalia, OH 45377-1932
Phone
(937) 208-7776
Fax
(937) 208-7751
NPI assigned
May 19, 2006
Last updated
Nov 8, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN FAMILY CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Authorized official

Name
Kenneth Prunier
Title
Ceo/President
Phone
(937) 208-8213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1 W National Rd
Vandalia, OH 45377-1932

Mailing address

1 W National Rd
Vandalia, OH 45377-1932
Phone (937) 208-7776

Other identifiers 1

IdentifierTypeStateIssuer
2029898MedicaidOH

Other names 1

  • Vandalia Family Care Doing business as

National Provider Directory

National Provider Directory
Part of
Cynthia L Pickens MD

Locations

810 Falls Creek Dr
#B
Vandalia, OH 45377
Phone (937) 298-2584

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1467405332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W NATIONAL RD",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771932",
            "telephone_number": "937-208-7776",
            "fax_number": "937-208-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W NATIONAL RD",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771932",
            "telephone_number": "937-208-7776",
            "fax_number": "937-208-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FAMILY CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN FAMILY CARE INC",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "937-208-8213"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029898",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vandalia Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vandalia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.