Active NPI
Victoria L Goodman, LPN
- Licensed Practical Nurse
- Festus, MO
National Provider Identifier
1073802302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 2010032651
- Practice address
- 227 E Main St
Festus, MO 63028-1952 - Phone
- (636) 321-0101
- Fax
- (636) 296-0101
- NPI assigned
- Apr 7, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 2010032651 | MO | Primary |
Addresses
Primary practice location
227 E Main St
Festus, MO 63028-1952
Mailing address
227 E Main St
Festus, MO 63028-1952
Phone (636) 321-0101
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010032651 | MO | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1073802302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 E MAIN ST",
"city": "FESTUS",
"state": "MO",
"postal_code": "630281952",
"telephone_number": "636-321-0101",
"fax_number": "636-296-0101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 E MAIN ST",
"city": "FESTUS",
"state": "MO",
"postal_code": "630281952",
"telephone_number": "636-321-0101",
"fax_number": "636-296-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "VICTORIA",
"middle_name": "L",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MO",
"license": "2010032651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Festus, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.