Active NPI
Camille Goff, PNP
- Pediatric Nurse Practitioner
- South Jordan, UT
National Provider Identifier
1629175047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 500898-8900
- Practice address
- 1268 W South Jordan Pkwy Ste 201
South Jordan, UT 84095-4653 - Phone
- (801) 254-9700
- Fax
- (801) 254-9755
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 500898-8900 | UT | Primary |
Addresses
Primary practice location
1268 W South Jordan Pkwy Ste 201
South Jordan, UT 84095-4653
Mailing address
13873 S Horizon Hills Circle
Herriman, UT 84065
Phone (801) 599-5458
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 |
|---|---|---|---|
| 500898-8900 | UT | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Families First Pediatrics LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- West Jordan, UT
- NPI 1821785270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629175047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13873 S HORIZON HILLS CIRCLE",
"city": "HERRIMAN",
"state": "UT",
"postal_code": "84065",
"telephone_number": "801-599-5458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1268 W SOUTH JORDAN PKWY STE 201",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840954653",
"telephone_number": "801-254-9700",
"fax_number": "801-254-9755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOFF",
"first_name": "CAMILLE",
"name_prefix": "Ms.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "UT",
"license": "500898-8900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.