Good Samaritan Nursing Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0001107 Issued in IL

Legal business name

GOOD SAMARITAN NURSING HOME

Practice address

407 N Hebard St
Knoxville, IL 61448-1174

Phone

(309) 289-2614

Fax

(309) 289-8847

NPI assigned

Mar 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Linda D. Cook

Title

Administrator

Phone

(309) 289-2614

Specialties & licenses 1

Addresses

Tax ID family

Good Samaritan Nursing Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Good Samaritan Nursing Home

  • Nursing Home Administrator
  • Knoxville, IL
  • NPI 1568483329
  NPD tax ID

Locations

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639138134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N. HEBARD STREET",
            "city": "KNOXVILLE",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-289-2614",
            "fax_number": "309-289-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N HEBARD ST",
            "city": "KNOXVILLE",
            "state": "IL",
            "postal_code": "614481174",
            "telephone_number": "309-289-2614",
            "fax_number": "309-289-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-289-2614",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0001107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annabelle Dayola-Ledford, APN
• East Belmont Dental
• Victoria Ann Fry
• Jinal Gala, M.S CFY-SLP
• Good Samaritan Nursing Home
• Clyde Grady
• Gyuchan H. Steele
• Alanna Jennings
• Knox County Nursing Home
• Michael Kotula, D.C.

• Nursing Facility/Intermediate Care Facility in Knoxville, IL
• Providers in Knoxville, IL by specialty
• Nursing Facility/Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.