Active NPI
Lyndsay M Goninen, RN
- Registered Nurse
- De Forest, WI
National Provider Identifier
1033405014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 178586-30
- Practice address
- 708 Acker Pkwy
De Forest, WI 53532-1149 - Phone
- (608) 574-8202
- NPI assigned
- Jun 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 178586-30 | WI | Primary |
Addresses
Primary practice location
708 Acker Pkwy
De Forest, WI 53532-1149
Mailing address
708 Acker Pkwy
De Forest, WI 53532-1149
Phone (608) 574-8202
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178586-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1033405014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 ACKER PKWY",
"city": "DE FOREST",
"state": "WI",
"postal_code": "535321149",
"telephone_number": "608-574-8202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 ACKER PKWY",
"city": "DE FOREST",
"state": "WI",
"postal_code": "535321149",
"telephone_number": "608-574-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONINEN",
"first_name": "LYNDSAY",
"middle_name": "M",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "178586-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Forest, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.