NPIMap

Organization Active NPI

Good Samaritan Home Care Services of Vincennes, in, LLC

  • Home Health Agency
  • Vincennes, IN
National Provider Identifier
1922092451
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES, IN, LLC
Practice address
328 N 2ND St Ste 300
Vincennes, IN 47591-1353
Phone
(812) 885-2767
Fax
(812) 885-2769
NPI assigned
Sep 12, 2005
Last updated
Jul 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Jack Hawkins
Title
VP Finance, Cfo
Phone
(513) 576-8478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

328 N 2ND St Ste 300
Vincennes, IN 47591-1353

Mailing address

6281 Tri Ridge Blvd Ste 300
Loveland, OH 45140-8345
Phone (513) 576-0262

Other identifiers 2

IdentifierTypeStateIssuer
200500550AMedicaidIN
200502090AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051011000959 IN Part A Provider - Home Health Agency 7517921489 Practice locations: Vincennes, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922092451. Details of each certification follow.

Home health agency certification: CCN 157217

Legal name
GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES IN, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 1, 1991
Last certification
Sep 17, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 1, 2004 in IN
Enrollment address
328 N 2ND St
Ste 300
Vincennes, IN 47591-1353
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Good Samaritan Home Care Services of Vincennes inCCN 157217 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
May 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0891284Good Samaritan Home Care Services of Vincennes, in328 N Second Street Suite C, Vincennes, IN 47591Certificate of waiverSep 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Home Care Services of Vincennes in LLC2 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.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1027 Washington Ave
#C
Vincennes, IN 47591

328 N 2nd St
Ste 300
Vincennes, IN 47591
Phone (812) 885-2767

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Adam L Thacker Individual Corporate OfficerBoard Member Jan 9, 2026
Tom Sayre Individual Corporate OfficerBoard Member Jan 1, 2026
Health at Home Holdco, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 33%
Brenda Winkler Individual Corporate OfficerBoard Member Jan 1, 2023
Rochelle Salinas Individual Corporate OfficerChairman/Board Member Jan 1, 2025
Patricia L Hedegard Individual Corporate OfficerBoard Member Jan 1, 2023
Commonspirit Health Organization, Englewood, CO Non-profit 5% Or Greater Indirect Ownership Interest Mar 30, 2011 100%
Commonspirit Health at Home, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 100%
Michelle L Moore Individual W-2 Managing EmployeeAd; Jan 1, 2025
Matthew Schuckman Individual Corporate OfficerCfo/Board Member Nov 19, 2021
Health at Home Blocker, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 67%
Consolidated Health Services LLC Organization, Loveland, OH LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2004 100%
American Nursing Care, LLC Organization, Loveland, OH LLC 5% Or Greater Direct Ownership Interest Dec 1, 2004 50%
Jack D Hawkins Individual Corporate OfficerVP Finance & Cfo Feb 1, 2022
Corporate DirectorVP Finance & Cfo Feb 1, 2022
Good Samaritan Hospital Organization, Vincennes, IN For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2004 50%

Owners & managing parties with NPI records 27

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 27

Facilities with the same owner 67

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 67

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 25

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1922092451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6281 TRI RIDGE BLVD STE 300",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451408345",
            "telephone_number": "513-576-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 N 2ND ST STE 300",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911353",
            "telephone_number": "812-885-2767",
            "fax_number": "812-885-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOME CARE SERVICES OF VINCENNES, IN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "VP FINANCE, CFO",
        "authorized_official_telephone_number": "513-576-8478"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200500550A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200502090A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.