Individual provider Active NPI

Martha Kate Goforth

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1538709688
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-148399 Issued in AL
Practice address
1802 6TH Ave S
Birmingham, AL 35233-1932
Phone
(205) 934-3411
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-148399 AL Primary

Addresses

Primary practice location

1802 6TH Ave S
Birmingham, AL 35233-1932

Mailing address

3761 Kinross Dr
Birmingham, AL 35242-5805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715001115 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153744727 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-148399ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 7, 2020 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

1802 6th Ave S
Birmingham, AL 35233
Phone (205) 934-5105

Interoperability endpoints

  • Direct secure messaging: mkgoforth@direct.uabmedicine.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1538709688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3761 KINROSS DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-934-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFORTH",
        "first_name": "MARTHA KATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-148399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.