Individual provider Active NPI

Gretchen L Reinfeldt-Goodell, NP

  • Women's Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1174544076
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP1984 Issued in AZ
Practice address
15255 N 40TH St
Suite 105
Phoenix, AZ 85032-4636
Phone
(602) 867-2690
Fax
(602) 404-1904
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP1984 AZ Primary

Addresses

Primary practice location

15255 N 40TH St
Suite 105
Phoenix, AZ 85032-4636

Mailing address

15255 N 40TH St
Suite105
Phoenix, AZ 85032-4636
Phone (602) 867-2690

Other identifiers 1

IdentifierTypeStateIssuer
RN092930OtherAZAZ LICENSE NUMBER

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP1984AZMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174544076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15255 N 40TH ST",
            "address_2": "SUITE105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324636",
            "telephone_number": "602-867-2690",
            "fax_number": "602-404-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15255 N 40TH ST",
            "address_2": "SUITE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324636",
            "telephone_number": "602-867-2690",
            "fax_number": "602-404-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINFELDT-GOODELL",
        "first_name": "GRETCHEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP1984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE NUMBER",
            "identifier": "RN092930",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.