NPIMap

Individual provider Active NPI

Deborah Lynn Goreham, FNP-C

  • Family Nurse Practitioner
  • Sonora, CA
National Provider Identifier
1083014559
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001269 Issued in CA
Practice address
690 Guzzi LN Ste C
Sonora, CA 95370-5292
Phone
(209) 533-0333
NPI assigned
Sep 3, 2014
Last updated
Sep 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001269 CA Primary

Addresses

Primary practice location

690 Guzzi LN Ste C
Sonora, CA 95370-5292

Mailing address

690 Guzzi LN Ste C
Sonora, CA 95370-5292
Phone (209) 533-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150209002172 CA Practitioner - Nurse Practitioner 8527383868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

18880 Cherry Valley Blvd
Tuolumne, CA 95379-9506
Phone (209) 928-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.19 of 100Reported as individual
Quality
90
Promoting interoperability
0
Improvement activities
40
Cost
83.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tuolumne Me-Wuk Indian Health Center, Inc. CurrentSince Dec 1, 2018 Accepting new patients
Tuolumne Mewuk Indian Health Center, Inc Family CurrentSince Dec 1, 2018 Accepting new patients

Locations

18880 Cherry Valley Blvd
Tuolumne, CA 95379
Phone (209) 928-5400

Interoperability endpoints

  • Direct secure messaging: deborah.goreham.p1@direct.tmwihc.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEBJCA/Endpoint/EEBJCA

Organizations & group practices 3

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1083014559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 GUZZI LN STE C",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705292",
            "telephone_number": "209-533-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 GUZZI LN STE C",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705292",
            "telephone_number": "209-533-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOREHAM",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.