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GOOD SAMARITAN SOCIETY - WAUKON
NPI 1912115635
Nursing Facility/Intermediate Care Facility in Waukon, IA

Active since May 18, 2007CLIA 16D0386360 · Waiver
21 E MAIN ST, WAUKON, IA 52172(563) 568-3447(563) 568-2459 Get Directions Write a Review

NPPES record last updated: October 9, 2007. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Good Samaritan Society - Waukon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOOD SAMARITAN SOCIETY - WAUKON (NPI 1912115635) is a healthcare organization registered as a nursing facility/intermediate care facility in Waukon, Iowa and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Raye Nae Nylander, Vice President, Cfo, as its authorized official.

NPPES Registry Identity

NPI1912115635
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameTHE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Location Address21 E MAIN STWaukon, IA 52172-1748
Mailing Address4800 W 57th StSioux Falls, SD 57108-2239 · (605) 362-3100
Phone(563) 568-3447
Fax(563) 568-2459
Organization SubpartYes
Authorized OfficialRaye Nae NylanderVice President, Cfo · (605) 362-3100
Enumeration DateMay 18, 2007
Last NPPES UpdateOctober 9, 2007
✔ NPI 1912115635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
21 E MAIN ST, Waukon, IA 52172
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Other Names 1

Doing Business AsGood Samaritan Society - Waukon

Other Identifiers 1

Medicaid0890137IA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D0386360

Good Samaritan Society - Waukon · Waukon, IA
Active · expires Aug 31, 2028
CLIA Number16D0386360
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorJessica Wilkins
Laboratory Phone(563) 568-3447
Laboratory LocationGood Samaritan Society - Waukon21 East Main Street, Waukon, IA 52172
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS JILLIAN RAE VOLKER M.A. CCC-SLP
Speech-Language Pathologist
21 E MAIN ST
WAUKON, IA 52172
Allamakee County (563) 568-3477
ANASTASIA ZINK OTA
Occupational Therapy Assistant
21 E MAIN ST
WAUKON, IA 52172
Allamakee County (563) 568-3447
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Skilled Nursing Facility
21 E MAIN ST
WAUKON, IA 52172
Allamakee County (563) 568-3447
LAUREN BRITTANY TEBRINK OTR/L
Occupational Therapist
21 E MAIN ST
WAUKON, IA 52172
Allamakee County (563) 568-3447

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Evangelical Lutheran Good Samaritan Society's NPI number?

The NPI number for The Evangelical Lutheran Good Samaritan Society is 1912115635. It was assigned to this organization in the NPPES registry on May 18, 2007. The provider is doing business as Good Samaritan Society - Waukon.

Where is The Evangelical Lutheran Good Samaritan Society located?

The Evangelical Lutheran Good Samaritan Society is located at 21 E Main St, Waukon, IA 52172. The listed phone number is (563) 568-3447.

What is The Evangelical Lutheran Good Samaritan Society's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does The Evangelical Lutheran Good Samaritan Society hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D0386360) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Evangelical Lutheran Good Samaritan Society was last updated on October 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.