Chioma Stella Goodluck, NURSE PRACTITIONER

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

737620-01 Issued in NY

Practice address

4217 Gunther Ave
Bronx, NY 10466-2007

Phone

(646) 382-1886

NPI assigned

Dec 7, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: cgoodluck2035018@nychhc.direct-ci.com
• Direct secure messaging: chioma.goodluck.1@30409.direct.athenahealth.com

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.

• Medical Care at Home PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1811138415
  Medicare reassignment NPD

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1477320679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 GUNTHER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662007",
            "telephone_number": "646-382-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 GUNTHER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662007",
            "telephone_number": "646-382-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLUCK",
        "first_name": "CHIOMA",
        "middle_name": "STELLA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F353448-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353448-01",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "737620-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Goodhall
• Dassetta Goodhall, LPN
• Jenenea Chanel Goodley
• Kimberly Narie Goodlitt-Creary, LMSW
• Emily Goodloe, MD
• Goodman Pharmacy LLC
• Goodman Plaza Pharmacy Inc
• Bryan Nicholas Goodman, DDS
• Marianne Goodman, M.D.
• Nina Glenda Goodman

• Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.