Priscilla Gooslin, CFNP
Individual provider Active NPI Nurse Practitioner · South Williamson, KY
NPI 1568414902 · NPPES record last updated Apr 27, 2021
Key facts
- NPI
- 1568414902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 42926 (WV)
- Practice address
- 306 Hospital Dr # 202D
South Williamson, KY 41503-4095 - Phone
- (606) 237-1516
- Fax
- (606) 237-4955
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050304000588 | KY | Practitioner - Nurse Practitioner | 4587616677 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42926 | WV | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Regional Healthcare, Inc. | Nurse Practitioner | Current |
Accepting new patients |
| Appalachian Regional Healthcare, Inc | Nurse Practitioner | Current | Accepting new patients |
| Appalachian Regional Healthcare, Inc | Current |
Accepting new patients | |
| Ashland Orthopedic Associates, P.S.C. | Past |
Accepting new patients | |
| Dr. Narpat S. Panwar, M.D., Inc. | Past |
Accepting new patients | |
| Appalachian Regional Healthcare, Inc. | Nurse Practitioner | Past |
Accepting new patients |
Locations
306 Hospital Dr
#202D
South Williamson, KY 41503
Phone (606) 237-1516
260 Hospital Dr
South Williamson, KY 41503
Phone (606) 237-1700
306 Hospital Dr
Ste 202D
South Williamson, KY 41503
306 Hospital Dr
South Williamson, KY 41503
Phone (606) 237-1700
306 Hospital Dr
#110A
South Williamson, KY 41503
Phone (606) 237-1740
Interoperability endpoints
- priscillagooslin@arh.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 42926 | WV | Yes |
Addresses
Primary practice location
306 Hospital Dr # 202D
South Williamson, KY 41503-4095
Mailing address
306 Hospital Dr Ste 202D
South Williamson, KY 41503-4095
Phone (606) 237-5800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810008931 | Medicaid | WV |
Other providers in South Williamson, KY
- Garett Charles Francis
- Mkayla Nicole Francis
- Javier Garcia
- Dana Jo Gillman-Butcher
- Olivia Rose Goad
- Mary Katherine Greene
- Zachary Grimmett
- Shobha Haridas
- Health Service Corporation
- Elliot Mika Hill
All providers in South Williamson, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.