Colleen King Goode, DNP, MA, FNP-BC, CNE

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R201512 Issued in MD

Practice address

1404 S Main Chapel Way Ste 104
Gambrills, MD 21054-1860

Phone

(443) 814-9108

NPI assigned

Aug 31, 2005

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

Other names 1

• Colleen Ann King Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

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.

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  • NPI 1144681263

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1508859984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2947 ROBIN RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174045769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 S MAIN CHAPEL WAY STE 104",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541860",
            "telephone_number": "443-814-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 E 33rd St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212183637",
            "country_code": "US",
            "telephone_number": "443-287-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODE",
        "first_name": "COLLEEN",
        "middle_name": "KING",
        "name_prefix": "Mrs.",
        "credential": "DNP, MA, FNP-BC, CNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "R201512",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R201512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "KING",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bernadine Geary, CRNP
• Joanna Judy Gilbert
• Linda Kathleen Girdner, PH.D., LCMFT
• Kiesha Glover, PT
• Tobi Goldstein, DPM
• Bruce Myron Gordon, PHARM.D.
• Scott Goyette, PT
• Greater Annapolis Oral & Maxillofacial Surgery
• Brenda Green
• Linda P Grierson, RN

• Family Nurse Practitioner in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.