Individual provider Active NPI

Marsha L Goodly

  • Community Health Registered Nurse
  • Lake Charles, LA
National Provider Identifier
1104181320
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN085620 Issued in LA
Practice address
3236 Kirkman St
Lake Charles, LA 70601-8640
Phone
(337) 480-2614
Fax
(337) 475-4820
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN085620 LA Primary

Addresses

Primary practice location

3236 Kirkman St
Lake Charles, LA 70601-8640

Mailing address

4135 Laredo Cir
Lake Charles, LA 70607-0954
Phone (337) 564-5672

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

LicenseStateTypeSpecialty
RN085620LAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1104181320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 LAREDO CIR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706070954",
            "telephone_number": "337-564-5672",
            "fax_number": "337-475-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 KIRKMAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018640",
            "telephone_number": "337-480-2614",
            "fax_number": "337-475-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLY",
        "first_name": "MARSHA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "LA",
            "license": "RN085620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.