The Evangelical Lutheran Good Samaritan Society

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Practice address

700 Clark St
Lodi, WI 53555-1010

Phone

(608) 592-3241

Fax

(608) 592-3293

NPI assigned

Dec 6, 2005

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

Ms. Raye Nae Nylander

Title

Cfo

Phone

(605) 362-3100

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Good Samaritan Society - Lodi Doing business as

Part of

Red Oak Iowa Good Sam C

Member of 1

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

• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Sioux Falls, SD
  • NPI 1952385015

  Member Of

  NPD member

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1992789523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 WEST 57TH STREET P.O. BOX 5038",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175038",
            "telephone_number": "605-362-3100",
            "fax_number": "605-362-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CLARK ST",
            "city": "LODI",
            "state": "WI",
            "postal_code": "535551010",
            "telephone_number": "608-592-3241",
            "fax_number": "608-592-3293"
        }
    ],
    "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": "2005-12-06",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "NYLANDER",
        "authorized_official_first_name": "RAYE NAE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-362-3100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "553711",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20150000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society - Lodi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marcia L Schaefer, DC
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• Thomas P Sullivan, MD
• Kelsey Transue
• Jillian Troxel, DPT
• Gregg William Wellner, RPH
• Marcie Marie Wenzel, COTA

• Skilled Nursing Facility in Lodi, WI
• Providers in Lodi, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.