Alicia Nicole Goodhart

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021012241 Issued in MO

Practice address

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049-8658

Phone

(573) 365-2318

Fax

(573) 365-3009

NPI assigned

May 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1497321723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 CORNETT BRANCH RD",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650499356",
            "telephone_number": "573-434-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 BAGNELL DAM BLVD",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498658",
            "telephone_number": "573-365-2318",
            "fax_number": "573-365-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODHART",
        "first_name": "ALICIA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021012241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole R Fuglsang, MA, LPC
• Brenn Robert Gent, LPC
• Larry Mark Goforth, D.C.
• Katrina Lynn Goldsberry, RN
• Kiem Goldsberry, RN
• Rhonda Groose
• Lisa K. Groves, OD
• Karen S. Hayes, N.P.
• Rebecca Hays, LCSW
• Grace Hegerfeld

• Family Nurse Practitioner in Lake Ozark, MO
• Providers in Lake Ozark, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.