Kristy Diane Goodson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-38393 Issued in ID

Practice address

1675 Curlew Dr
Ammon, ID 83406-4718

Phone

(208) 523-5319

NPI assigned

Nov 30, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

4 Pillars of Success LLCGroup PAC ID 4688027188, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 4 Pillars of Success LLC

  • Multi-Specialty Clinic/Center
  • Ammon, ID
  • NPI 1619134277

  Clinical, ID

  Medicare reassignment Care Compare group NPD
• 4 Pillars of Success LLC

  • Clinic/Center
  • Ammon, ID
  • NPI 1992487615

  Social Worker

  NPD

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

{
    "created_epoch": "1385769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1194156216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2106",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032106",
            "telephone_number": "208-523-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064718",
            "telephone_number": "208-523-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "KRISTY",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-30",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-38393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
• Kristine George
• Carl L. Giauque, O.D.
• Gailen Gifford, CFSS
• Marci Gonzalez
• Tiffany Rose Grant, LCSW
• Greater Good Health PC Inc
• Greater Good Health PC, Inc.
• Jennifer Griffin
• Kathryn Griggs

• Clinical Social Worker in Ammon, ID
• Providers in Ammon, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.