Individual provider Active NPI

Lajeune Joann McGoldrick, RN

  • Registered Nurse
  • Tulsa, OK
National Provider Identifier
1033627708
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
5862 Issued in OK
Practice address
2405 S Phoenix Ave
Tulsa, OK 74107-2850
Phone
(918) 664-4224
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 5862 OK Primary

Addresses

Primary practice location

2405 S Phoenix Ave
Tulsa, OK 74107-2850

Mailing address

2405 S Phoenix Ave
Tulsa, OK 74107-2850
Phone (918) 664-4224

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

LicenseStateTypeSpecialty
5862OKMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1033627708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 S PHOENIX AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741072850",
            "telephone_number": "918-664-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 S PHOENIX AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741072850",
            "telephone_number": "918-664-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOLDRICK",
        "first_name": "LAJEUNE",
        "middle_name": "JOANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "5862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.