Reba Goodrow, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9240 Issued in CT

Practice address

1 Pomperaug Office Park Ste 102&103
Southbury, CT 06488-2295

Phone

(203) 558-1143

NPI assigned

Oct 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640995200000",
    "number": "1003413634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 CENTRAL AVE",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067163002",
            "telephone_number": "203-589-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 POMPERAUG OFFICE PARK STE 102&103",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882295",
            "telephone_number": "203-558-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODROW",
        "first_name": "REBA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2022-01-01",
        "certification_date": "2022-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Southbury, CT
• Providers in Southbury, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2022; 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.