The Good Samaritan Free Clinic, Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

RN9338409 Issued in FL

Legal business name

THE GOOD SAMARITAN FREE CLINIC, INC

Practice address

2601 Virginia Ave
Fort Pierce, FL 34981-5539

Phone

(772) 924-1137

NPI assigned

Apr 21, 2014

Organization subpart

No

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

Authorized official

Name

Eva Bryant, R.N.

Title

Executive Assistant

Phone

(772) 879-9383

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evangelina Bryant, ARNP

  • Family Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1538673645
  NPD (past)

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1760802458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3035",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349483035",
            "telephone_number": "772-924-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 VIRGINIA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815539",
            "telephone_number": "772-924-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD SAMARITAN FREE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "772-879-9383",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "RN9338409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fort Pierce, FL
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.