Individual provider Active NPI

Kallina Goldsby, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Davenport, IA
National Provider Identifier
1649160359
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G185308 Issued in IA
Practice address
430 W. 35TH Street
Suite 7
Davenport, IA 52806
Phone
(563) 279-2017
NPI assigned
Jul 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G185308 IA Primary

Addresses

Primary practice location

430 W. 35TH Street
Suite 7
Davenport, IA 52806

Mailing address

19120 134TH Ave W
Taylor Ridge, IL 61284-9100
Phone (309) 269-5185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19120 134TH Ave W
Taylor Ridge, IL 61284-9100

430 W 35TH St
Stop 7
Davenport, IA 52806-5820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G185308IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellnest of the Quad Cities CurrentSince Jul 28, 2025 Accepting new patients

Locations

430 W 35th St
Stop 7
Davenport, IA 52806
Phone (563) 279-2017

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.

NPI Registry JSON

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

{
    "created_epoch": "1751587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1649160359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19120 134TH AVE W",
            "city": "TAYLOR RIDGE",
            "state": "IL",
            "postal_code": "612849100",
            "telephone_number": "309-269-5185",
            "fax_number": "563-205-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W. 35TH STREET",
            "address_2": "SUITE 7",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52806",
            "telephone_number": "563-279-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSBY",
        "first_name": "KALLINA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G185308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.