Individual provider Active NPI

Nancy Amber Goudas, NP

  • Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1396292017
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
500891 Issued in NC
Practice address
2406 Century PL SE
Hickory, NC 28602-4031
Phone
(828) 324-9550
Fax
(828) 324-4154
NPI assigned
Sep 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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 500891 NC
Nurse Practitioner 363L00000X 500891 NC Primary

Addresses

Primary practice location

2406 Century PL SE
Hickory, NC 28602-4031

Mailing address

PO Box 3710
Hickory, NC 28603-3710
Phone (828) 324-9550

Other practice location 1

339 Nebo School Rd
Nebo, NC 28761-6848
Phone (828) 652-6326

Other names 1

  • Nancy Amber Rowe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20161103001272 NC Practitioner - Nurse Practitioner 4789962234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
500891NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Oncology Specialist PA CurrentSince Jan 22, 2024 Accepting new patients

Locations

2406 Century Pl SE
Hickory, NC 28602
Phone (828) 324-9550

Organizations & group practices 1

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": "1473552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1396292017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3710",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286033710",
            "telephone_number": "828-324-9550",
            "fax_number": "828-324-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 CENTURY PL SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024031",
            "telephone_number": "828-324-9550",
            "fax_number": "828-324-4154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 Nebo School Rd",
            "address_purpose": "LOCATION",
            "city": "Nebo",
            "state": "NC",
            "postal_code": "287616848",
            "country_code": "US",
            "telephone_number": "828-652-6326",
            "fax_number": "828-652-5625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUDAS",
        "first_name": "NANCY",
        "middle_name": "AMBER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-11",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "500891",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "500891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "ROWE",
            "middle_name": "AMBER",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.