Kelly Ann Gooch, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024187187 Issued in VA

Practice address

19500 Sandridge Way Ste 280
Leesburg, VA 20176-3690

Phone

(703) 723-1757

NPI assigned

Mar 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Shady Grove Fertility Reproductive Science Center

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  • NPI 1891849832
  NPD (past)
• Shady Grove Reproductive Science Center PC

  • Ambulatory Surgical Clinic/Center
  • Rockville, MD
  • NPI 1437232758
  NPD (past)

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1477312692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 CHESTNUT HILL LN",
            "city": "MARSHALL",
            "state": "VA",
            "postal_code": "201152117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY STE 280",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763690",
            "telephone_number": "703-723-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001259062",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024187187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter David Goldberg, MS
• Rebecca Golden
• Amanda Jane Golino, DNP, APRN
• Sandra Santa Barbara Goncalves, PSY.D, LCP
• Miguel H Gonzalez
• David Peter Goodfriend, MD
• Aubrey Christine Goodwin, NP
• Elizabeth (Betsy) G Goodwin, LCSW
• Nancy H Gordon, MA, CCC-SLP
• Gavin Blair Gore

• Nurse Practitioner in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.