NPIMap

Organization Active NPI

Good Samaritan Family Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vincennes, IN
National Provider Identifier
1679282164
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GOOD SAMARITAN FAMILY HEALTH CENTER, INC.
Practice address
515 Bayou St
Vincennes, IN 47591-1034
Phone
(812) 886-6800
Fax
(812) 886-6809
NPI assigned
Nov 23, 2022
Last updated
Mar 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GOOD SAMARITAN FAMILY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Jennifer Emmons
Title
Ceo
Phone
(812) 494-7800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

515 Bayou St
Vincennes, IN 47591-1034

Mailing address

PO Box 556
Vincennes, IN 47591-0556
Phone (812) 494-9501

Other practice location 1

2007 State St
Washington, IN 47501-8505
Phone (812) 254-1558

Other practice location 2

1901 Willow St
Vincennes, IN 47591-4277
Phone (812) 494-9515

Other practice location 3

611 E Main St Ste 110
Petersburg, IN 47567-1270
Phone (812) 354-8785

Other practice location 4

200 S John F Kennedy Ave
Loogootee, IN 47553-1624
Phone (812) 295-3090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190219002426 IN Part B Supplier - Clinic/Group Practice 5294099321 Receives reassigned benefits from 59 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Loogootee, IN; Washington, IN; Vincennes, IN; Petersburg, IN

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Family Health Center Inc31 organizations share this tax ID, including this one
Part of
Good Samaritan Family Health Center Inc

Other organizations with this tax ID 30

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

View all 30

Locations

1545 S Hart Street Rd
Fl 1
Vincennes, IN 47591
Phone (812) 885-8720

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1679282164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475910556",
            "telephone_number": "812-494-9501",
            "fax_number": "812-494-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BAYOU ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911034",
            "telephone_number": "812-886-6800",
            "fax_number": "812-886-6809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2007 State St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IN",
            "postal_code": "475018505",
            "country_code": "US",
            "telephone_number": "812-254-1558",
            "fax_number": "812-254-8308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Willow St",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475914277",
            "country_code": "US",
            "telephone_number": "812-494-9515",
            "fax_number": "812-494-9514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 E Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "IN",
            "postal_code": "475671270",
            "country_code": "US",
            "telephone_number": "812-354-8785",
            "fax_number": "812-354-8786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 S John F Kennedy Ave",
            "address_purpose": "LOCATION",
            "city": "Loogootee",
            "state": "IN",
            "postal_code": "475531624",
            "country_code": "US",
            "telephone_number": "812-295-3090",
            "fax_number": "812-295-4328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOOD SAMARITAN FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SAMARITAN FAMILY HEALTH CENTER, INC.",
        "enumeration_date": "2022-11-23",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "EMMONS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-494-7800"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.