NPIMap

Individual provider Active NPI

Diane S Goebel, M.D.

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1225030935
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5529 Issued in NV
Practice address
2350 W Horizon Ridge Pkwy
Henderson, NV 89052-5075
Phone
(702) 564-8556
Fax
(702) 564-4485
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5529 NV Primary

Addresses

Primary practice location

2350 W Horizon Ridge Pkwy
Henderson, NV 89052-5075

Mailing address

2350 W Horizon Ridge Pkwy
Henderson, NV 89052-5075
Phone (702) 564-8556

Other identifiers 2

IdentifierTypeStateIssuer
003102184MedicaidNV
002018184MedicaidNV

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5529NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Misch/Hyun/Hodapp Healthcare, LLP Pediatrics Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Organizations & group practices 7

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1225030935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525075",
            "telephone_number": "702-564-8556",
            "fax_number": "702-564-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525075",
            "telephone_number": "702-564-8556",
            "fax_number": "702-564-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEBEL",
        "first_name": "DIANE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "5529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003102184",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018184",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.