NPIMap

Individual provider Active NPI

Christine Gooley, APRN

  • Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1225112188
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
081836-23 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-6060
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 081836-23 NH Primary
Nurse Practitioner 363L00000X 101-0021875 VT

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-6060

Other identifiers 1

IdentifierTypeStateIssuer
101-0021875OtherVTLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060505000534 VT Practitioner - Certified Clinical Nurse Specialist (CNS) 3971514928 Reassigns benefits to 1 organization
I20200515001130 NH Practitioner - Nurse Practitioner 3971514928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081836-23NHMDNurse Practitioner
101-0021875VTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Retreat CurrentSince Sep 15, 2014 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince May 15, 2020 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince May 15, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince May 15, 2020 Accepting new patients
Brattleboro Retreat Past Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

Interoperability endpoints

  • Direct secure messaging: cgooley393611@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225112188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLEY",
        "first_name": "CHRISTINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-07-21",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "081836-23",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VT",
            "license": "101-0021875",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "101-0021875",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.