Active NPI
The Evangelical Lutheran Good Samaritan Society
- Skilled Nursing Facility
- Gibbon, NE
National Provider Identifier
1497736896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- Practice address
- 1011 7TH St
Gibbon, NE 68840-6004 - Phone
- (308) 468-5353
- Fax
- (308) 468-5658
- NPI assigned
- Nov 11, 2005
- Organization subpart
- Yes
- Parent organization
- THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Raye Nae Nylander
- Title
- Cfo
- Phone
- (605) 362-3100
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary | ||
| Nursing Facility Supplies (DME) | 332BN1400X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X |
Addresses
Primary practice location
1011 7TH St
Gibbon, NE 68840-6004
Mailing address
PO Box 5038
4800 West 57TH Street
Sioux Falls, SD 57117-5038
Phone (605) 362-3100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F248045 | Other | NE | MIDLANDS CHOICE |
| 00567 | Other | NE | BLUE CROSS BLUE SHIELD |
Other names 1
- Good Samaritan Society - Gibbon
National Provider Directory
National Provider Directory- Part of
- Red Oak Iowa Good Sam C
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1356566400000",
"number": "1497736896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5038",
"address_2": "4800 WEST 57TH STREET",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175038",
"telephone_number": "605-362-3100",
"fax_number": "605-362-3265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 7TH ST",
"city": "GIBBON",
"state": "NE",
"postal_code": "688406004",
"telephone_number": "308-468-5353",
"fax_number": "308-468-5658"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
"enumeration_date": "2005-11-11",
"last_updated": "2012-12-27",
"status": "A",
"authorized_official_last_name": "NYLANDER",
"authorized_official_first_name": "RAYE NAE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "605-362-3100",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "F248045",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00567",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Good Samaritan Society - Gibbon",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gibbon, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.