GOOD SAMARITAN REGIONAL HEALTH CENTER NPI 1487758801

NPI Information

NPI: 1487758801
Provider Name: GOOD SAMARITAN REGIONAL HEALTH CENTER
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Doing Business As: SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON
Address: 1 GOOD SAMARITAN WAY
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 899-4600

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NPI Details

GOOD SAMARITAN REGIONAL HEALTH CENTER is an emergency medicine in Mount Vernon, IL. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. GOOD SAMARITAN REGIONAL HEALTH CENTER NPI is 1487758801. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Ssm Health Good Samaritan Hospital - Mt. Vernon.

The provider's business location address is:

1 GOOD SAMARITAN WAY
MOUNT VERNON, IL
ZIP 62864-402
Phone: (618) 899-4600
Fax: (618) 532-9365

The provider's authorized official is Jeremy Bradford .
The authorized official title is President and has the following contact phone number (618) 899-1001.

The enumeration date for this NPI number is 9/8/2006 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208100000X	Physical Medicine & Rehabilitation		0004705	ILLINOIS	No
2	2084N0400X	Psychiatry & Neurology	Neurology	0004705	ILLINOIS	No
3	207RI0011X	Internal Medicine	Interventional Cardiology	0004705	ILLINOIS	No
4	2085R0001X	Radiology	Radiation Oncology	0004705	ILLINOIS	No
5	2085R0202X	Radiology	Diagnostic Radiology	0004705	ILLINOIS	No
6	227800000X	Respiratory Therapist, Certified		0004705	ILLINOIS	No
7	227900000X	Respiratory Therapist, Registered		0004705	ILLINOIS	No
8	207P00000X	Emergency Medicine		0004705	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4115179	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD
2	33898	OTHER	ILLINOIS	GROUP HEALTH PLAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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