Pamela Goines, CNP
Individual provider Active NPI Family Nurse Practitioner · Willard, OH
NPI 1194132365 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1194132365
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.16194 (OH)
- Practice address
- 1509 S Conwell Ave
Willard, OH 44890-9448 - Phone
- (419) 964-5140
- Fax
- (419) 964-5722
- NPI assigned
- Jul 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Physicians North Specialty Care LLC
Practice addresses (Care Compare)
3900 Sunforest CT
Suite 240
Toledo, OH 43623-4481
Phone (419) 475-1600
Hospital & facility affiliations
- Mercy Health - Willard Hospital
- Mercy Health - Tiffin Hospital
- Avita Ontario
- Bucyrus Community Hospital
- Ohiohealth Shelby Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140909000505 | OH | Practitioner - Nurse Practitioner | 5597984450 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.16194 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Physicians-North LLC | Current |
Accepting new patients | |
| Mercy Health Physicians - North, LLC | Current |
Accepting new patients | |
| Mercy Health Physicians North Specialty Care LLC | Nurse Practitioner | Current |
Accepting new patients |
| Mercy Health Physicians North Specialty Care LLC | Current |
Accepting new patients | |
| Sandusky Wellness DME LLC | Past | Accepting new patients |
Locations
45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900
3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126
2213 Cherry St
Ste 200
Toledo, OH 43608
Phone (419) 251-4283
2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013
1100 Neal Zick Rd
Fl 2
Willard, OH 44890
1100 Neal Zick Rd
Willard, OH 44890
Phone (419) 933-2811
1509 S Conwell Ave
Willard, OH 44890
Phone (419) 933-4424
Interoperability endpoints
- pgoines211864@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.16194 | OH | Yes |
Addresses
Primary practice location
1509 S Conwell Ave
Willard, OH 44890-9448
Mailing address
1509 S Conwell Ave
Willard, OH 44890-9448
Phone (419) 964-5140
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0108561 | Medicaid | OH |
Other providers in Willard, OH
- Alice Marie Frazier-Snook
- Lillian Marie Freeman
- Rodica Gavrila
- Barbara Ann Gerber
- Gohar Ghazarian
- Kenneth Leon Gortz
- Nina Gregory
- Angela Marie Hamons
- Gladys Hauler
- Chad Michael Herner
All providers in Willard, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.