Active NPI
Douglas Herman Goke, LICSW
- Clinical Social Worker
- Faribault, MN
National Provider Identifier
1568746469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 807
- Practice address
- 1500 Wellington Cres
Faribault, MN 55021-6731 - Phone
- (507) 333-5708
- NPI assigned
- Oct 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 807 | MN | Primary |
Addresses
Primary practice location
1500 Wellington Cres
Faribault, MN 55021-6731
Mailing address
1500 Wellington Cres
Faribault, MN 55021-6731
Phone (507) 333-5708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 807 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1568746469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 WELLINGTON CRES",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550216731",
"telephone_number": "507-333-5708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WELLINGTON CRES",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550216731",
"telephone_number": "507-333-5708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOKE",
"first_name": "DOUGLAS",
"middle_name": "HERMAN",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Faribault, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.