Active NPI
Carly A Goolbis
- Student in an Organized Health Care Education/Training Program
- West Lebanon, NH
National Provider Identifier
1134880750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 24 Airport Rd Ste 19
West Lebanon, NH 03784-1663 - Phone
- (603) 562-5715
- NPI assigned
- Jan 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | ID | Primary |
Addresses
Primary practice location
24 Airport Rd Ste 19
West Lebanon, NH 03784-1663
Mailing address
24 Airport Rd Ste 19
West Lebanon, NH 03784-1663
Phone (603) 562-5715
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenientmd LLC | 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.
-
- Urgent Care Clinic/Center
- Newburyport, MA
- NPI 1316428824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1134880750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 AIRPORT RD STE 19",
"city": "WEST LEBANON",
"state": "NH",
"postal_code": "037841663",
"telephone_number": "603-562-5715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 AIRPORT RD STE 19",
"city": "WEST LEBANON",
"state": "NH",
"postal_code": "037841663",
"telephone_number": "603-562-5715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOLBIS",
"first_name": "CARLY",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-05",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.