NPIMap

Organization Active NPI

The Evangelical Lutheran Good Samaritan Society

Doing business as Good Samaritan Society - Manor On Main

  • Nursing Facility/Intermediate Care Facility
  • Noonan, ND
National Provider Identifier
1699757005
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Doing business as
Good Samaritan Society - Manor On Main
Practice address
301 Main Ave
Noonan, ND 58765-0069
Phone
(701) 925-5670
Fax
(701) 925-5718
NPI assigned
Nov 19, 2005
Last updated
Oct 12, 2007By 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 Oct 12, 2007

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

Authorized official

Name
Ms. Raye Nae Nylander
Title
Cfo
Phone
(605) 362-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

301 Main Ave
Noonan, ND 58765-0069

Mailing address

PO Box 5038
Sioux Falls, SD 57117-5038
Phone (605) 362-3100

Other identifiers 1

IdentifierTypeStateIssuer
30711MedicaidND

Other names 1

  • Good Samaritan Society - Manor On Main 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 21

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

View all 21

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": "1132358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1699757005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5038",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175038",
            "telephone_number": "605-362-3100",
            "fax_number": "605-362-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN AVE",
            "city": "NOONAN",
            "state": "ND",
            "postal_code": "587650069",
            "telephone_number": "701-925-5670",
            "fax_number": "701-925-5718"
        }
    ],
    "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": "2005-11-19",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "NYLANDER",
        "authorized_official_first_name": "RAYE NAE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-362-3100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30711",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society - Manor On Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Noonan, ND

Sources for this page

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