Individual provider Active NPI

Clarisse Justine Goas, APRN-CNP

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1427305127
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.13676 Issued in OH
Practice address
480 Medical Center Dr
Columbus, OH 43210-1229
Phone
(614) 293-4969
Fax
(614) 366-2210
NPI assigned
Aug 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.13676 OH Primary

Addresses

Primary practice location

480 Medical Center Dr
Columbus, OH 43210-1229

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-4969

Other identifiers 1

IdentifierTypeStateIssuer
0072301MedicaidOH

Other names 1

  • Clarisse Justine Evans Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20121009000479 OH Practitioner - Nurse Practitioner 7618126566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu Neuroscience Center LLCGroup PAC ID 8820990161, 115 clinicians

Practice addresses (Care Compare)

480 Medical Ctr Dr
Columbus, OH 43210-1229
Phone (614) 293-4969

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Neuroscience Center LLC CurrentSince Dec 15, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Osu Neuroscience Center, LLC Past Accepting new patients

Locations

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

480 Medical Center Dr
Columbus, OH 43210
Phone (614) 293-3830

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

6700 University Blvd
Ste 5A
Dublin, OH 43016

Interoperability endpoints

  • Direct secure messaging: cevans806237@direct.osumc.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1427305127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-4969",
            "fax_number": "614-366-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MEDICAL CENTER DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101229",
            "telephone_number": "614-293-4969",
            "fax_number": "614-366-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOAS",
        "first_name": "CLARISSE",
        "middle_name": "JUSTINE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.13676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072301",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARISSE",
            "last_name": "EVANS",
            "middle_name": "JUSTINE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.