Goma Mayberry

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN9308893 Issued in FL

Practice address

773 Riverside Dr
Ormond Beach, FL 32176-7878

Phone

(386) 795-2457

NPI assigned

Jan 20, 2017

Last updated

Jan 20, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians

Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Kashyap Patel MD PAGroup PAC ID 9830152974, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: goma.mayberry@kpmp-fl.direct.office.nextgen.com

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.

• Kashyap Patel MD PA

  dba A-one family Practice

  • Family Medicine Physician
  • Ormond Beach, FL
  • NPI 1114037462
  Medicare reassignment Care Compare group
• Volusia & Flagler OB-GYN PA

  • Specialist
  • Ormond Beach, FL
  • NPI 1932371598
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halifax Hospital Medical Center

  dba Halifax Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1588101174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 RIVERSIDE DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321767878",
            "telephone_number": "386-795-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 RIVERSIDE DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321767878",
            "telephone_number": "386-795-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "GOMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9308893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailee Massebeau, RDN/LDN
• Laurel Mathias
• Matt Nirschl D C LLC
• David Weston Maxwell, DMD
• Maybach Neurosurgery Clinic LLC
• Shelley Mayo
• Jocelyn Marie Mazelow, PHARMD
• Larry Mazzarella, CNIM
• Troy James McAuliff, PTA, ATC
• Casie McCallister

• Family Nurse Practitioner in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.