Individual provider Active NPI

Gretchen Laurel Goodnight, ANP

  • Family Nurse Practitioner
  • Mena, AR
National Provider Identifier
1134425705
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A003488 Issued in AR
Practice address
403 Morrow St N Ste D
Mena, AR 71953-4324
Phone
(479) 437-6080
Fax
(479) 437-6079
NPI assigned
Jan 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A003488 AR Primary

Addresses

Primary practice location

403 Morrow St N Ste D
Mena, AR 71953-4324

Mailing address

403 Morrow St N Ste D
Mena, AR 71953-4324
Phone (479) 437-6080

Other identifiers 2

IdentifierTypeStateIssuer
195568758MedicaidAR
2I7543OtherARMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20110318000784 AR Practitioner - Nurse Practitioner 1355524968 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goodnight Family Healthcare PLLC CurrentSince Sep 1, 2022 Accepting new patients
Williams Medical Clinic PastSince Oct 31, 2006 Accepting new patients

Locations

403 Morrow St N
Ste F
Mena, AR 71953
Phone (479) 437-6080

403 Morrow St N
Ste D
Mena, AR 71953
Phone (479) 437-6080

403 Morrow St N
Ste E
Mena, AR 71953
Phone (479) 243-9024

Interoperability endpoints

  • Direct secure messaging: glgoodnight@goodnightfamilyhealthcare.kareodirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1134425705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 MORROW ST N STE D",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534324",
            "telephone_number": "479-437-6080",
            "fax_number": "479-437-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MORROW ST N STE D",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534324",
            "telephone_number": "479-437-6080",
            "fax_number": "479-437-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODNIGHT",
        "first_name": "GRETCHEN",
        "middle_name": "LAUREL",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195568758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2I7543",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mena, AR

Sources for this page

Verify at the official NPI Registry.