Goodheart Medical Group

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

APRN000597 Issued in NV

Legal business name

GOODHEART MEDICAL GROUP

Practice address

1316 E Calvada Blvd
Pahrump, NV 89048-5692

Phone

(775) 751-6111

NPI assigned

Jul 8, 2014

Organization subpart

No

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

Authorized official

Name

Renae Goedhart, APRNNPI 1275585382

Title

Owner

Phone

(702) 682-8155

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Tax ID family

Goedhart Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Goedhart Medical Group

  • Family Nurse Practitioner
  • Pahrump, NV
  • NPI 1578976619
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renae Sue Goedhart, APRN

  • Family Nurse Practitioner
  • Pahrump, NV
  • NPI 1275585382
  Medicare reassignment NPD Authorized official
• Shannon Denise Brecik, FNP

  • Family Nurse Practitioner
  • Newport, OR
  • NPI 1295279404
  NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1467868679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890411089",
            "telephone_number": "702-682-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 E CALVADA BLVD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485692",
            "telephone_number": "775-751-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODHEART MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "GOEDHART",
        "authorized_official_first_name": "RENAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-682-8155",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NV",
            "license": "APRN000597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa R Gomez
• Nicholas Albert Gonzales, LMSW
• Arturo Gonzalez
• Rosio Gonzalez, APRN
• Amber Lynne Goodeman, OTR/L
• Angela Christina Goodman
• Renee Grandieri-Fluker, A.P.N.
• Jennifer Granger
• Grgich PC
• Grgich PC

• Health Service Clinic/Center in Pahrump, NV
• Providers in Pahrump, NV by specialty
• Health Service Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.