Individual provider Active NPI

Stephanie D Goodman, CNP

  • Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1104016518
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
301784 Issued in OH
Practice address
285 E State St
Suite 150
Columbus, OH 43215-4354
Phone
(614) 460-6100
NPI assigned
Aug 1, 2007
Last updated
Sep 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 301784 OH Primary

Addresses

Primary practice location

285 E State St
Suite 150
Columbus, OH 43215-4354

Mailing address

PO Box 182255
Columbus, OH 43218-2255
Phone (614) 430-5712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20080507000344 OH Practitioner - Nurse Practitioner 6103905757 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
301784OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hypertension Nephrology Consultants Inc CurrentSince Sep 1, 2007 Accepting new patients

Locations

285 E State St
Ste 150
Columbus, OH 43215

500 E Main St
Ste 240
Columbus, OH 43215
Phone (614) 566-8570

Interoperability endpoints

  • Direct secure messaging: sgoodman21337@direct.acumenmd.com

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, 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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1104016518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182255",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432182255",
            "telephone_number": "614-430-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 E STATE ST",
            "address_2": "SUITE 150",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154354",
            "telephone_number": "614-460-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "301784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.