Active NPI
Robin Renae Goss, OTRL
- Occupational Therapist
- Latham, NY
National Provider Identifier
1003919614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0038091
- Practice address
- 711 Troy Schenectady Rd
Thomas Nicolla Consulting Suite 209
Latham, NY 12110 - Phone
- (518) 786-1667
- Fax
- (518) 786-1954
- NPI assigned
- Sep 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0038091 | NY | Primary |
Addresses
Primary practice location
711 Troy Schenectady Rd
Thomas Nicolla Consulting Suite 209
Latham, NY 12110
Mailing address
13 Kling Terrace
Voorheesville, NY 12186-9545
Phone (518) 765-4351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03173131 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003809 | NY | MD | Acupuncturist |
| 0038091 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1003919614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 KLING TERRACE",
"city": "VOORHEESVILLE",
"state": "NY",
"postal_code": "121869545",
"telephone_number": "518-765-4351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD",
"address_2": "THOMAS NICOLLA CONSULTING SUITE 209",
"city": "LATHAM",
"state": "NY",
"postal_code": "12110",
"telephone_number": "518-786-1667",
"fax_number": "518-786-1954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSS",
"first_name": "ROBIN",
"middle_name": "RENAE",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "0038091",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03173131",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.