Individual provider Active NPI

Kimberly Ann Goodman, FNP-C

  • Family Nurse Practitioner
  • Pikeville, KY
National Provider Identifier
1639886740
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4007192 Issued in KY
Practice address
911 Bypass Rd BLDG a
Pikeville, KY 41501-1602
Phone
(606) 430-3500
Fax
(606) 218-4651
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 114352 WV
Family Nurse Practitioner 363LF0000X 4007192 KY Primary

Addresses

Primary practice location

911 Bypass Rd BLDG a
Pikeville, KY 41501-1602

Mailing address

PO Box 432
Pikeville, KY 41502-0432
Phone (606) 430-2201

Other practice location 1

221 4th Ave
Saint Albans, WV 25177-2821
Phone (304) 525-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231009000064 WV Practitioner - Nurse Practitioner 0648625848 Reassigns benefits to 1 organization
I20231213001943 KY Practitioner - Nurse Practitioner 0648625848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

911 Bypass Rd
BLDG a
Pikeville, KY 41501-1689
Phone (606) 430-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
81.47
Promoting interoperability
100
Improvement activities
40
Cost
81.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4007192KYMDFamily Nurse Practitioner
114352WVMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Hospitalist Group Inc CurrentSince Jul 26, 2023 Accepting new patients
Pikeville Medical Center Inc CurrentSince Nov 6, 2023 Accepting new patients
Huntington Hospitalist Group Inc CurrentSince Jul 26, 2023 Accepting new patients
Huntington Hospitalist Group Inc CurrentSince Jul 26, 2023 Accepting new patients
Pikeville Medical Center Inc. CurrentSince Nov 6, 2023 Accepting new patients
Pikeville Medical Center Inc Past Accepting new patients

Locations

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

2828 1st Ave
Ste 204
Huntington, WV 25702
Phone (304) 525-7111

221 4th Ave
Saint Albans, WV 25177
Phone (304) 414-4873

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1639886740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415020432",
            "telephone_number": "606-430-2201",
            "fax_number": "606-218-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD BLDG A",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011602",
            "telephone_number": "606-430-3500",
            "fax_number": "606-218-4651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Albans",
            "state": "WV",
            "postal_code": "251772821",
            "country_code": "US",
            "telephone_number": "304-525-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "114352",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4007192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.