Individual provider Active NPI

Kelly C. Goode, APRN

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1467894170
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5402 Issued in CT
Practice address
2800 Main St
Bridgeport, CT 06606-4201
Phone
(203) 683-5100
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5402 CT Primary

Addresses

Primary practice location

2800 Main St
Bridgeport, CT 06606-4201

Mailing address

2800 Main St
Bridgeport, CT 06606-4201
Phone (203) 576-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140612001726 CT Practitioner - Nurse Practitioner 2062636038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

112 Quarry Rd
Suite 400
Trumbull, CT 06611-4877
Phone (203) 333-8800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Jan 23, 2017 Accepting new patients
Neighborhood Health, Inc. Family CurrentSince Oct 1, 2013 Accepting new patients
Heart Specialists PC of Southern Connecticut Past Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

2979 Main St
Bridgeport, CT 06606
Phone (203) 333-8800

1152 Kings Highway Cutoff
Fairfield, CT 06824
Phone (203) 256-5500

84 Oxford Rd
Oxford, CT 06478
Phone (203) 881-0830

4 Corporate Dr
Ste 100
Shelton, CT 06484
Phone (203) 384-8960

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

112 Quarry Rd
Ste 400
Trumbull, CT 06611
Phone (203) 333-8800

Interoperability endpoints

  • Direct secure messaging: kgoode355517@direct.ynhh.org

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 2

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1467894170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-683-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "KELLY",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.