Individual provider Active NPI

Ramona Lynn Goolsby, APRN-CNP

  • Family Nurse Practitioner
  • Idabel, OK
National Provider Identifier
1326006768
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0058803 Issued in OK
Practice address
601 SE Washington St
Idabel, OK 74745-3319
Phone
(580) 286-6699
Fax
(580) 286-6699
NPI assigned
May 3, 2006
Last updated
Jun 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0058803 OK Primary
Family Nurse Practitioner 363LF0000X 594059 TX

Addresses

Primary practice location

601 SE Washington St
Idabel, OK 74745-3319

Mailing address

601 SE Washington St
Idabel, OK 74745-3319
Phone (580) 286-6688

Other identifiers 1

IdentifierTypeStateIssuer
200086610-AMedicaidOK

Other names 1

  • Mrs. Ramona Lynn Clawson Former name

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
R0058803OKMDFamily Nurse Practitioner
594059TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Advanced Heart Care PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1326006768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE WASHINGTON ST",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747453319",
            "telephone_number": "580-286-6688",
            "fax_number": "580-286-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SE WASHINGTON ST",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747453319",
            "telephone_number": "580-286-6699",
            "fax_number": "580-286-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "RAMONA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0058803",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "594059",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200086610-A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAMONA",
            "last_name": "CLAWSON",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "APRN-CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idabel, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.