Individual provider Active NPI

Dayna Marie Goetz, RN

  • Case Management Registered Nurse
  • Manitowoc, WI
National Provider Identifier
1427790815
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
136396-30 Issued in WI
Practice address
1346 Westwood LN
Manitowoc, WI 54220-1602
Phone
(920) 655-7010
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC0400X 136396-30 WI Primary

Addresses

Primary practice location

1346 Westwood LN
Manitowoc, WI 54220-1602

Mailing address

1346 Westwood LN
Manitowoc, WI 54220-1602
Phone (920) 655-7010

Other identifiers 2

IdentifierTypeStateIssuer
000MedicaidWI
000OtherWIINDEPENDENT HEALTH PROVIDER

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
136396-30WIMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1427790815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 WESTWOOD LN",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542201602",
            "telephone_number": "920-655-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 WESTWOOD LN",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542201602",
            "telephone_number": "920-655-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "DAYNA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "WI",
            "license": "136396-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH PROVIDER",
            "identifier": "000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.