The Evangelical Lutheran Good Samaritan Society

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Practice address

913 Col Pete St S
Clear Lake, SD 57226-2124

Phone

(605) 874-2159

Fax

(605) 874-8449

NPI assigned

Aug 13, 2018

Organization subpart

Yes

Parent organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

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

Authorized official

Name

George Grant Tribble

Title

Executive VP

Phone

(605) 362-3900

Specialties & licenses 1

Addresses

Other names 1

• Good Samaritan Society -Deuel County Doing business as

Part of

Red Oak Iowa Good Sam C

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534118400000",
    "number": "1902385693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 COL PETE ST S",
            "city": "CLEAR LAKE",
            "state": "SD",
            "postal_code": "572262124",
            "telephone_number": "605-874-2159",
            "fax_number": "605-874-8449"
        }
    ],
    "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": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A",
        "authorized_official_last_name": "TRIBBLE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "605-362-3900"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society -Deuel County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sanford Health Network
• Sanford Health Network
• Angela Seuser, AU.D.
• Terrance H Smith, M.D.
• The Evangelical Lutheran Good Samaritan Society
• Toben Chiropractic Prof LLC
• Mark A Vossler, MD
• Larry James Wittmeier, PHARMACIST

• Nurse Practitioner in Clear Lake, SD
• Providers in Clear Lake, SD by specialty
• Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.