Active NPI
Kimberly Goehl, APN
- Adult Health Nurse Practitioner
- Naperville, IL
National Provider Identifier
1093016842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 209008170
- Practice address
- 3 N. Washington St.
Naperville, IL 60540 - Phone
- (630) 357-6540
- Fax
- (630) 357-6435
- NPI assigned
- Nov 10, 2010
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209008170 | IL | Primary |
Addresses
Primary practice location
3 N. Washington St.
Naperville, IL 60540
Mailing address
3 N Washington St FL 2
Naperville, IL 60540-4780
Phone (630) 357-6540
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 |
|---|---|---|---|
| 209008170 | IL | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randy S. Morris, MD, SC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1093016842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 N WASHINGTON ST FL 2",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605404780",
"telephone_number": "630-357-6540",
"fax_number": "630-357-6435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 N. WASHINGTON ST.",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "60540",
"telephone_number": "630-357-6540",
"fax_number": "630-357-6435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEHL",
"first_name": "KIMBERLY",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-10",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209008170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.