Individual provider Active NPI

Ida Louise Goodnight, CRNA

  • Certified Registered Nurse Anesthetist
  • Hickory, NC
National Provider Identifier
1023263886
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
145803 Issued in NC
Practice address
810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone
(828) 326-3809
Fax
(828) 326-3371
NPI assigned
Nov 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 145803 NC Primary

Addresses

Primary practice location

810 Fairgrove Church Rd
Hickory, NC 28602-9617

Mailing address

810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone (828) 326-3809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000564 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305901786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical CenterGroup PAC ID 0547178907, 105 clinicians

Practice addresses (Care Compare)

810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone (828) 326-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
145803NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center CurrentSince Nov 20, 2008 Accepting new patients
Catawba Valley Medical Center Current Accepting new patients
Catawba Valley Medical Center CurrentSince Nov 20, 2008 Accepting new patients

Locations

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1023263886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617",
            "telephone_number": "828-326-3809",
            "fax_number": "828-326-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617",
            "telephone_number": "828-326-3809",
            "fax_number": "828-326-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODNIGHT",
        "first_name": "IDA",
        "middle_name": "LOUISE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "145803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.