Individual provider Active NPI

Perry Chet Goldstein, RN, BSN,CMSRN

  • Medical-Surgical Registered Nurse
  • York, ME
National Provider Identifier
1043247828
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
RN 52296 Issued in ME
Practice address
647 US Route 1
#14149
York, ME 03909-1689
Phone
(207) 272-4787
Fax
(207) 221-1273
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN 52296 ME Primary
Case Management Registered Nurse 163WC0400X RN 52296 ME
Home Health Registered Nurse 163WH0200X RN 52296 ME
Gerontology Registered Nurse 163WG0600X RN 52296 ME
General Practice Registered Nurse 163WG0000X RN 52296 ME

Addresses

Primary practice location

647 US Route 1
#14149
York, ME 03909-1689

Mailing address

647 US Route 1
#14149
York, ME 03909-1689
Phone (207) 272-4787

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 52296MEMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1043247828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 US ROUTE 1",
            "address_2": "#14149",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091689",
            "telephone_number": "207-272-4787",
            "fax_number": "207-221-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 US ROUTE 1",
            "address_2": "#14149",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091689",
            "telephone_number": "207-272-4787",
            "fax_number": "207-221-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "PERRY",
        "middle_name": "CHET",
        "name_prefix": "Mr.",
        "credential": "RN, BSN,CMSRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "ME",
            "license": "RN 52296",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "ME",
            "license": "RN 52296",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "ME",
            "license": "RN 52296",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "ME",
            "license": "RN 52296",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "ME",
            "license": "RN 52296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.