The Evangelical Lutheran Good Samaritan Society

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Doing business as

Good Samaritan Society - Barbour County

Practice address

216 Samaritan Cir
Belington, WV 26250-8141

Phone

(304) 823-2555

Fax

(304) 823-3136

NPI assigned

Oct 13, 2016

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

Grant Tribble

Title

Executive VP - Finance

Phone

(605) 362-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Good Samaritan Society - Barbour County Doing business as

Tax ID family

Evangelical Lutheran Good210 organizations share this tax ID, including this one

Part of

Evangelical Lutheran Good

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1982154993",
    "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",
            "telephone_number": "605-362-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SAMARITAN CIR",
            "city": "BELINGTON",
            "state": "WV",
            "postal_code": "262508141",
            "telephone_number": "304-823-2555",
            "fax_number": "304-823-3136"
        }
    ],
    "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": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "TRIBBLE",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "EXECUTIVE VP - FINANCE",
        "authorized_official_telephone_number": "605-362-3100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002975000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society - Barbour County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cierra Terry
• Tabatha Tetrick
• Melinda Tharp
• Tommy Tharp
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Barbour County)
• Whitney Theriot
• Kristen Thomas
• Makayia Thomas
• Sarah Thomas
• Stacy Thompson

• Physical Therapy Clinic/Center in Belington, WV
• Providers in Belington, WV by specialty
• Physical Therapy Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.