Good Samaritan Nursing Home, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GOOD SAMARITAN NURSING HOME, LLC

Practice address

32900 Detroit Rd
Avon, OH 44011-2018

Phone

(440) 937-0410

Fax

(440) 937-9384

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William Shackleford, LNHA

Title

Administrator

Phone

(440) 937-0410

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982807954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32900 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112018",
            "telephone_number": "440-937-0410",
            "fax_number": "440-937-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32900 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112018",
            "telephone_number": "440-937-0410",
            "fax_number": "440-937-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN NURSING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHACKLEFORD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "440-937-0410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2339697",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Rae Goebel, MD
• Lester Goetz, PT
• Andrew Shirali Goldblum, DO
• Golden Pathways Senior Care & Solutions LLC
• Good Samaritan Health Group, Inc
• Donna Goodwin, APRN, CNP
• Irene Chryssovalantou Grabovac, NP
• Grady Podiatry LLC
• Kristina Grasso, PT, DPT
• Great Lakes Podiatry Center Inc

• Skilled Nursing Facility in Avon, OH
• Providers in Avon, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.