Individual provider Active NPI

Misty R Goldson, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Somerset, KY
National Provider Identifier
1528069531
Registry record updated Feb 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3004253 Issued in KY
Practice address
600 Monticello St Ste 1
Somerset, KY 42501-2974
Phone
(606) 400-2227
Fax
(606) 332-0576
NPI assigned
Aug 2, 2005
Last updated
Feb 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3004253 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3004253 KY Primary

Addresses

Primary practice location

600 Monticello St Ste 1
Somerset, KY 42501-2974

Mailing address

PO Box 142
Burnside, KY 42519-0142
Phone (606) 400-2227

Other names 1

  • Miss Misty R Decker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20070809000660 KY Practitioner - Nurse Practitioner 4688640360 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Monticello St
Suite 1
Somerset, KY 42501-2974
Phone (606) 400-2227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southfork Medical Clinic PLLC CurrentSince Mar 21, 2016 Accepting new patients
Quest Counseling Nurse Practitioner CurrentSince Feb 1, 2023 Accepting new patients
Southfork Medical Clinic PLLC CurrentSince Mar 21, 2016 Accepting new patients
Cumberland Family Clinic, PLLC CurrentSince Mar 21, 2016 Accepting new patients
Enlighten Mental Wellness LLC Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

10550 S Highway 27
Ste 3
Burnside, KY 42519

57 Hogue Rd
Pine Knot, KY 42635
Phone (606) 354-9444

600 Clifty St
Ste 2
Somerset, KY 42503
Phone (606) 678-0026

600 Monticello St
Ste 1
Somerset, KY 42501
Phone (606) 400-2227

71 Medical Ln
Whitley City, KY 42653
Phone (606) 376-7212

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1528069531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 142",
            "city": "BURNSIDE",
            "state": "KY",
            "postal_code": "425190142",
            "telephone_number": "606-400-2227",
            "fax_number": "606-332-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MONTICELLO ST STE 1",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012974",
            "telephone_number": "606-400-2227",
            "fax_number": "606-332-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSON",
        "first_name": "MISTY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3004253",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3004253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "DECKER",
            "middle_name": "R",
            "prefix": "MISS",
            "credential": "PMHNP, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.