Jill C Goldberg, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

002713 Issued in CT

Practice address

1 Bonnybrook Rd
Norwalk, CT 06850-2703

Phone

(203) 247-9636

NPI assigned

Feb 13, 2008

Last updated

Nov 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCDGCD

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.

• Spiralpath Healing Center, LLC.

  • Holistic Clinical Nurse Specialist
  • Norwalk, CT
  • NPI 1053709535

  Pediatrics

  NPD (past) Authorized official
• Norwalk Community Health Center Inc

  • Health Service Clinic/Center
  • Norwalk, CT
  • NPI 1841226347
  NPD
• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  NPD (past)

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1386812238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BONNYBROOK RD",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068502703",
            "telephone_number": "203-247-9636",
            "fax_number": "203-956-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BONNYBROOK RD",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068502703",
            "telephone_number": "203-247-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JILL",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "002713",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Lewis Glazer, MD
• Aynur Gojayeva, D.M.D.
• Gold Coast Residence and Services Company
• Beth Michelle Goldberg, D.D.S.
• Cindy Lara Goldberg, M.D.
• Lloyd Ira Goldberg, DDS
• Melissa Amy Goldring, RPT
• Robert Neil Goldring, DC
• Edward Joseph Gombos, D.M.D.
• Gilda M Gomez

• Pediatric Nurse Practitioner in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.