Carly Goldbeck

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G154997 Issued in IA

Practice address

2277 Iowa Ave
Independence, IA 50644-9106

Phone

(319) 334-2583

NPI assigned

Sep 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carly Germaine Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mental Health Institute

  • Psychiatry Physician
  • Independence, IA
  • NPI 1023069440
  Medicare reassignment NPD
• Mental Health Institute

  • Psychiatric Hospital
  • Independence, IA
  • NPI 1841279239
  NPD

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1417508375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBECK",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G154997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "GERMAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fuelling Chiropractic Clinic PC
• Matthew Patrick Fuelling, D.C.
• Full Circle Services
• Mindy Ann Fults, RPH
• Kara Gelwicks
• Penney S Hackert, LPN
• Leah Lorayne Halverson, DPT
• George M. Harper, ED.D.
• Hartig Drug Co Corp
• Timothy Merwyn Hartsook, D.D.S.

• Psychiatric/Mental Health Nurse Practitioner in Independence, IA
• Providers in Independence, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.