Mary Goodspeed, PMHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

72002 Issued in ID

Practice address

300 S 23Rd St
Boise, ID 83702-9100

Phone

(208) 344-3512

Fax

(208) 466-5359

NPI assigned

Mar 17, 2022

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgoodspeed337537@direct.ochin.org

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

• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1457309122

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Community Health Clinics, Inc.

  dba Terry Reilly - Vista

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1346254026
  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Middleton, ID
  • NPI 1962788315

  Nurse Practitioner

  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Meridian, ID
  • NPI 1215941083

  Nurse Practitioner

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1588678361

  Nurse Practitioner

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1689688459
  NPD (past)

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1053069047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 23RD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837029100",
            "telephone_number": "208-344-3512",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSPEED",
        "first_name": "MARY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "72002",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "72002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cyle Goodman, M.D.
• Julie Ann Goodman, LCSW
• Samantha Tess Goodrich
• George William Goodridge, ATC, EMC
• Brieana Goods
• Amina Nyoka Goodwin, M.D.
• Kelli J Goold, CFA
• Tobias P Gopon, MD
• James A Gorczyca, D.D.S.
• Nicholas Tyler Gorden

• Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.