Active NPI
Nikki Goodale, OTR, CLT
- Occupational Therapist
- Paris, TX
National Provider Identifier
1386098523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 114230
- Practice address
- 2710 E Price St
Paris, TX 75460 - Phone
- (903) 784-3173
- Fax
- (903) 784-7912
- NPI assigned
- Apr 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 114230 | TX | Primary |
Addresses
Primary practice location
2710 E Price St
Paris, TX 75460
Mailing address
1849 Lamar Ave Ste 120
Paris, TX 75460-1463
Phone (903) 316-6386
Other practice location 1
205 E Commerce St
Suite 209
Jacksonville, TX 75766-4970
Phone (903) 316-6386
Other practice location 2
1849 LaMar Ave Ste 120
Paris, TX 75460
Phone (903) 316-6386
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114230 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Focus Center, LLC | Past | Accepting new patients | |
| Chambers Outpatient Rehab Services, LLC | Occupational Therapist | 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 and National Provider Directory roles.
-
- Physical Therapist
- Mt Pleasant, TX
- NPI 1356538136
Occupational Therapist
-
- Clinical Social Worker
- Paris, TX
- NPI 1831658293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553558400000",
"number": "1386098523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1849 LAMAR AVE STE 120",
"city": "PARIS",
"state": "TX",
"postal_code": "754601463",
"telephone_number": "903-316-6386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 E PRICE ST",
"city": "PARIS",
"state": "TX",
"postal_code": "75460",
"telephone_number": "903-784-3173",
"fax_number": "903-784-7912"
}
],
"practiceLocations": [
{
"address_1": "205 E Commerce St",
"address_2": "Suite 209",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "TX",
"postal_code": "757664970",
"country_code": "US",
"telephone_number": "903-316-6386",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1849 LaMar Ave Ste 120",
"address_purpose": "LOCATION",
"city": "Paris",
"state": "TX",
"postal_code": "75460",
"country_code": "US",
"telephone_number": "903-316-6386",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOODALE",
"first_name": "NIKKI",
"credential": "OTR, CLT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-13",
"last_updated": "2019-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paris, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.