Active NPI
Atosha Goodman
- Community Health Worker
- Springfield, MO
National Provider Identifier
1083447304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 2650 W Kearney St
Springfield, MO 65803-2037 - Phone
- (417) 865-1547
- NPI assigned
- Aug 22, 2024
- Last updated
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MO | Primary | |
| Pharmacy Technician | 183700000X | 2018002759 | MO |
Addresses
Primary practice location
2650 W Kearney St
Springfield, MO 65803-2037
Mailing address
5039 S Fieldstone Rd
Battlefield, MO 65619-8406
Phone (417) 274-8420
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 |
|---|---|---|---|
| 2018002759 | MO | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Food Merchants LLC | Current | Accepting new patients | |
| Food Merchants LLC | Past | Accepting new patients |
Locations
2650 W Kearney St
Springfield, MO 65803
Phone (417) 865-1547
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1083447304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5039 S FIELDSTONE RD",
"city": "BATTLEFIELD",
"state": "MO",
"postal_code": "656198406",
"telephone_number": "417-274-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 W KEARNEY ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658032037",
"telephone_number": "417-865-1547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "ATOSHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2024-08-22",
"certification_date": "2024-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MO",
"license": null,
"primary": true
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MO",
"license": "2018002759",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.