Active NPI
Shelby Doris Goodman
- Nurse Practitioner
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R39844
- Practice address
- 700 1St Ave S
Fargo, ND 58103-1802 - Phone
- (701) 234-2000
- Fax
- (701) 234-4134
- NPI assigned
- Apr 16, 2021
- Last updated
- Oct 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R39844 | ND | Primary |
Addresses
Primary practice location
700 1St Ave S
Fargo, ND 58103-1802
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other practice location 1
5225 23rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2000
Other names 1
- Shelby Doris Rossow
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1200
1412 Main St
Hawley, MN 56549
Phone (218) 483-3564
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.39 of 100
- Quality
- 91.62
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 66.36
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9989 | MN | MD | Physician Assistant |
| R39844 | ND | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933
700 1st Ave S
Fargo, ND 58103
Phone (701) 234-4023
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Organizations & group practices 2
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.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
MN
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital
-
dba Sanford Physical Therapy
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
dba Perham Health
- Family Medicine Physician
- Perham, MN
- NPI 1457631814
Hospital
-
dba Sanford Bemidji
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1457932964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-6585",
"fax_number": "605-312-9802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 1ST AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581031802",
"telephone_number": "701-234-2000",
"fax_number": "701-234-4134"
}
],
"practiceLocations": [
{
"address_1": "5225 23rd Ave S",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581047927",
"country_code": "US",
"telephone_number": "701-417-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOODMAN",
"first_name": "SHELBY",
"middle_name": "DORIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-16",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ND",
"license": "R39844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHELBY",
"last_name": "ROSSOW",
"middle_name": "DORIS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.