NPIMap

Organization Active NPI

The Evangelical Lutheran Good Samaritan Society

Doing business as Augusta Place - a Prospera Community

  • Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1528540317
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Doing business as
Augusta Place - a Prospera Community
Practice address
301 Lorrain Dr
Bismarck, ND 58503-0311
Phone
(701) 255-1084
Fax
(701) 751-1342
NPI assigned
Aug 29, 2018
Last updated
Nov 25, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Eric Vanden Hull
Title
Vice President, Finance
Phone
(605) 362-5510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

301 Lorrain Dr
Bismarck, ND 58503-0311

Mailing address

4800 W 57TH St
Sioux Falls, SD 57108-2239

Other names 1

  • Augusta Place - a Prospera Community Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Home210 organizations share this tax ID, including this one
Part of
Good Samaritan Home

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1528540317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LORRAIN DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030311",
            "telephone_number": "701-255-1084",
            "fax_number": "701-751-1342"
        }
    ],
    "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": "2018-08-29",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "VANDEN HULL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VICE PRESIDENT, FINANCE",
        "authorized_official_telephone_number": "605-362-5510"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Augusta Place - a Prospera Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.