Individual provider Active NPI

Halie Goffrier, PA-C

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1629023866
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00995 Issued in OR
Practice address
2478 13TH St SE
Salem, OR 97302-2546
Phone
(503) 362-2481
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00995 OR Primary

Addresses

Primary practice location

2478 13TH St SE
Salem, OR 97302-2546

Mailing address

2478 13TH St SE
Salem, OR 97302-2522
Phone (503) 362-2481

Other identifiers 2

IdentifierTypeStateIssuer
032458MedicaidOR
500636798MedicaidOR

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060327000424 OR Practitioner - Physician Assistant 7315955796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: halie.goffrier.p23@direct.wvp.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1629023866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022522",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022546",
            "telephone_number": "503-362-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFFRIER",
        "first_name": "HALIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032458",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500636798",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.