Individual provider Active NPI

Jade Goodloe, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1124531132
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9338023 Issued in FL
Practice address
1437 S Belcher Rd
Clearwater, FL 33764-2829
Phone
(727) 524-4464
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN9338023 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9338023 FL Primary

Addresses

Primary practice location

1437 S Belcher Rd
Clearwater, FL 33764-2829

Mailing address

1437 S Belcher Rd
Clearwater, FL 33764-2829
Phone (727) 524-4464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180423000738 FL Practitioner - Nurse Practitioner 3274896444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9338023FLMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1124531132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 S BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642829",
            "telephone_number": "727-524-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 S BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642829",
            "telephone_number": "727-524-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLOE",
        "first_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "RN9338023",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9338023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.