Healthcare Provider Details

I. General information

NPI: 1033036652
Provider Name (Legal Business Name): SAMANTHA GOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 N BANK DR
COLUMBUS OH
43220-5420
US

IV. Provider business mailing address

2515 ASCHINGER BLVD
COLUMBUS OH
43212-2686
US

V. Phone/Fax

Practice location:
  • Phone: 614-442-6515
  • Fax:
Mailing address:
  • Phone: 740-497-0591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN.515482
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: