NPIMap

Organization Active NPI

The Good Samaritan Hospital

  • Vascular & Interventional Radiology Physician
  • Lebanon, PA
National Provider Identifier
1609953751
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
072401 Issued in PA
Legal business name
THE GOOD SAMARITAN HOSPITAL
Practice address
Fourth and Walnut Streets
Lebanon, PA 17042
Phone
(717) 274-7580
Fax
(717) 228-0249
NPI assigned
Nov 1, 2006
Organization subpart
Yes
Parent organization
THE GOOD SAMARITAN HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Robert J Richards
Title
VP Finance & Cfo
Phone
(717) 270-7806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X 072401 PA Primary

Addresses

Primary practice location

Fourth and Walnut Streets
Lebanon, PA 17042

Mailing address

PO Box 1281
Lebanon, PA 17042-1281
Phone (717) 274-7580

Other identifiers 9

IdentifierTypeStateIssuer
1365655OtherPAHIGHMARK BLUE SHIELD
521957OtherGEISINGER GOLD
1365655OtherHIGHMARK FREEDOM BLUE
521957OtherSTERLING OPTION 1
521957OtherHUMANA GOLD
521957OtherRAILROAD MEDICARE
1521465OtherPAGATEWAY MEDICARE ASSURED
521957OtherADVANTRA
521957OtherPABS 65(MEDIGAP CROSS OVER)

National Provider Directory

National Provider Directory
Part of
Hyman S Caplan Pav GSH

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1609953751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1281",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170421281",
            "telephone_number": "717-274-7580",
            "fax_number": "717-228-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOURTH AND WALNUT STREETS",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-274-7580",
            "fax_number": "717-228-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD SAMARITAN HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GOOD SAMARITAN HOSPITAL",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP FINANCE & CFO",
        "authorized_official_telephone_number": "717-270-7806"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "072401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1365655",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER GOLD",
            "identifier": "521957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK FREEDOM BLUE",
            "identifier": "1365655",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING OPTION 1",
            "identifier": "521957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD",
            "identifier": "521957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "521957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1521465",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA",
            "identifier": "521957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS 65(MEDIGAP CROSS OVER)",
            "identifier": "521957",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.