Individual provider Active NPI

Karen M Goodman, ARNP

  • Family Nurse Practitioner
  • Lynden, WA
National Provider Identifier
1285655969
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30004920 Issued in WA
Practice address
1610 Grover St
Suite D1
Lynden, WA 98264-1539
Phone
(360) 354-1333
Fax
(360) 354-5399
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30004920 WA Primary

Addresses

Primary practice location

1610 Grover St
Suite D1
Lynden, WA 98264-1539

Mailing address

709 W Orchard Dr
Suire 4
Bellingham, WA 98225-1766
Phone (360) 318-8800

Other identifiers 6

IdentifierTypeStateIssuer
423898057OtherWAGROUP HEALTH COOPERATIVE
0500009160OtherWARAILROAD MEDICARE
42079OtherWAREGENCE BLUESHIELD
8924736OtherWAL & I (CRIME VICTIM)
0128913OtherWAL & I (REGULAR)
9625161MedicaidWA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30004920WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Network PLLC CurrentSince Mar 1, 1999 Accepting new patients
Family Care Network PLLC CurrentSince Mar 1, 1999 Accepting new patients
Family Care Network PLLC Current Accepting new patients

Locations

1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785

Organizations & group practices 3

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1285655969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W ORCHARD DR",
            "address_2": "SUIRE 4",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251766",
            "telephone_number": "360-318-8800",
            "fax_number": "360-318-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 GROVER ST",
            "address_2": "SUITE D1",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641539",
            "telephone_number": "360-354-1333",
            "fax_number": "360-354-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30004920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH COOPERATIVE",
            "identifier": "423898057",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0500009160",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "42079",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I (CRIME VICTIM)",
            "identifier": "8924736",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I (REGULAR)",
            "identifier": "0128913",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9625161",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynden, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.