Angela S Goodson-Acevedo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209015423 Issued in IL

Practice address

14121 Parke Long CT
Chantilly, VA 20151-1647

Phone

(571) 449-3585

NPI assigned

Dec 4, 2017

Sex

Female

Sole proprietor

No

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• CMC Healthcare LLC

  • Nurse Practitioner
  • Evanston, IL
  • NPI 1295432334
  Medicare reassignment Care Compare group NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1245745967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "571-449-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "571-449-3585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9125 S Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608051441",
            "country_code": "US",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODSON-ACEVEDO",
        "first_name": "ANGELA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theo Marroig Goering
• Amaya Yiqin Golabek
• Mary Elizabeth Goldman
• Deborah Gonzalez, MA, LPC
• Paige Goodman
• David S Goodwin, M.D.
• Krista Goovaerts, M.A., CCC-SLP
• Michelle Gorden, LPC
• Vijaya Lakshmi Gorle, M.D.
• Irini Gouda, PHYSICAL THERAPY

• Family Nurse Practitioner in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.