Good Samaritan Hospital

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

IS302 Issued in WA

Legal business name

GOOD SAMARITAN HOSPITAL

Practice address

3901 S Fife St
Tacoma, WA 98409-7309

Phone

(253) 301-6400

Fax

(253) 301-6528

NPI assigned

Aug 17, 2005

Organization subpart

No

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

Authorized official

Name

John R Long, MS,RN,CHCE,CDHP

Title

President

Phone

(253) 301-6400

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• MultiCare Good Samaritan Home Health Doing business as

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1609868413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150200",
            "telephone_number": "253-301-6400",
            "fax_number": "253-301-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 S FIFE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097309",
            "telephone_number": "253-301-6400",
            "fax_number": "253-301-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-301-6400",
        "authorized_official_credential": "MS,RN,CHCE,CDHP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IS302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HOME HEALTH",
            "identifier": "GO1222",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9007618",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "0439370003",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "WA2923",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9166505",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS HOME HEALTH",
            "identifier": "0004",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "1258",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MultiCare Good Samaritan Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Gonzalez
• Jessica Patricia Gonzalez
• Mayra Gonzalez, CDPT
• Miguel Angel Gonzalez
• Quang Luu Gonzalez, MD
• Deborah Lynne Good, RN
• James A. Good, R.PH.
• McKayla Marie Good, LICSW
• Patrick S Good, L.M.P.
• Lily Goodall

• Home Health Agency in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Home Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.