Individual provider Active NPI

Cheryl Louise Goforth, APRN, BC

  • Family Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1477653970
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000005366 Issued in TN
Practice address
200 New York Ave
Ste 160
Oak Ridge, TN 37830-5212
Phone
(865) 835-5138
Fax
(865) 835-5139
NPI assigned
Sep 24, 2006
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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 APN0000005366 TN Primary

Addresses

Primary practice location

200 New York Ave
Ste 160
Oak Ridge, TN 37830-5212

Mailing address

200 New York Ave
Ste 160
Oak Ridge, TN 37830-5212
Phone (865) 835-5138

Other identifiers 1

IdentifierTypeStateIssuer
1522208MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN0000005366TNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1477653970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE",
            "address_2": "STE 160",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305212",
            "telephone_number": "865-835-5138",
            "fax_number": "865-835-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE",
            "address_2": "STE 160",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305212",
            "telephone_number": "865-835-5138",
            "fax_number": "865-835-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFORTH",
        "first_name": "CHERYL",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000005366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522208",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.