Individual provider Active NPI

Nicole Elizabeth Eidson, FNP-C

  • Family Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1558514745
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP116912 Issued in TX
Practice address
1855 Gattis School Rd
Round Rock, TX 78664-7428
Phone
(866) 389-2727
Fax
(401) 216-2854
NPI assigned
Oct 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704446455 MI
Family Nurse Practitioner 363LF0000X 898780 NV
Family Nurse Practitioner 363LF0000X C-APN.0106146-C-NP CO
Family Nurse Practitioner 363LF0000X 236750 AR
Family Nurse Practitioner 363LF0000X 116848 NE
Family Nurse Practitioner 363LF0000X C-RXN.0104112-C-NP CO
Family Nurse Practitioner 363LF0000X 3281616 ID
Family Nurse Practitioner 363LF0000X 245905 LA
Family Nurse Practitioner 363LF0000X AP3167 AZ
Family Nurse Practitioner 363LF0000X 58957 WY
Family Nurse Practitioner 363LF0000X R0113798 OK
Family Nurse Practitioner 363LF0000X 3-002919 AL
Family Nurse Practitioner 363LF0000X A190163 IA
Family Nurse Practitioner 363LF0000X AP116912 TX Primary

Addresses

Primary practice location

1855 Gattis School Rd
Round Rock, TX 78664-7428

Mailing address

1855 Gattis School Rd
Round Rock, TX 78664-7428
Phone (866) 389-2727

Other practice location 1

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Other practice location 2

1825 E Warm Springs Rd
Las Vegas, NV 89119-4547
Phone (866) 389-2727

Other practice location 3

4401 S Claiborne Ave
New Orleans, LA 70125-5105
Phone (866) 389-2727

Other practice location 4

1466 W Oak St
Zionsville, IN 46077-1800
Phone (866) 389-2727

Other practice location 5

1520 S Bryant Ave
Edmond, OK 73013-6028
Phone (866) 389-2727

Other practice location 6

39350 9 Mile Rd
Northville, MI 48167-9164
Phone (248) 735-6081

Other practice location 7

5566 S 56th St
Lincoln, NE 68516-1834
Phone (866) 389-2727

Other practice location 8

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Other practice location 9

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Other names 1

  • Nicole Eidson Goodman Former name

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3-002919ALMDFamily Nurse Practitioner
236750ARMDFamily Nurse Practitioner
AP3167AZMDFamily Nurse Practitioner
C-APN.0106146-C-NPCOMDFamily Nurse Practitioner
C-RXN.0104112-C-NPCOMDFamily Nurse Practitioner
A190163IAMDFamily Nurse Practitioner
3281616IDMDFamily Nurse Practitioner
245905LAMDFamily Nurse Practitioner
4704446455MIMDFamily Nurse Practitioner
116848NEMDFamily Nurse Practitioner
898780NVMDFamily Nurse Practitioner
R0113798OKMDFamily Nurse Practitioner
AP116912TXMDFamily Nurse Practitioner
58957WYMDFamily Nurse Practitioner

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1558514745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 GATTIS SCHOOL RD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647428",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 GATTIS SCHOOL RD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647428",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-2854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Cvs Dr",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028956146",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 E Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891194547",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 S Claiborne Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701255105",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1466 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Zionsville",
            "state": "IN",
            "postal_code": "460771800",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1520 S Bryant Ave",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730136028",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "39350 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481679164",
            "country_code": "US",
            "telephone_number": "248-735-6081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5566 S 56th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685161834",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Cvs Dr",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028956146",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Cvs Dr",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028956146",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIDSON",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704446455",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "898780",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0106146-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "236750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "116848",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-RXN.0104112-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "3281616",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "245905",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3167",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "58957",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0113798",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-002919",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A190163",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP116912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GOODMAN",
            "middle_name": "EIDSON",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.