Nicole B. Goodson, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YSOO593600 Issued in NJ

Practice address

1064 S Main St
West Creek, NJ 08092-2912

Phone

(609) 448-2650

Fax

(609) 488-2651

NPI assigned

Apr 15, 2011

Last updated

Jan 25, 2014By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Home Rehabilitation, LLCGroup PAC ID 0345418646, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Coastal Home Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Belmar, NJ
  • NPI 1316236664
  Medicare reassignment Care Compare group NPD
• Shore to Advance Therapy Services

  • Physical Therapist
  • Little Egg Harbor TWP, NJ
  • NPI 1962833160

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390608000000",
    "number": "1649560228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 WIMBLETON LN",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080879654",
            "telephone_number": "609-879-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 S MAIN ST",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080922912",
            "telephone_number": "609-448-2650",
            "fax_number": "609-488-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "NICOLE",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2014-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YSOO593600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE PATHOLOGIST",
            "identifier": "41YSOO593600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Promise of the Jersey Shore
• Doreen Ferraro
• G. Hoegler Counseling LLC
• Madison Gates
• Georgianna Emily Gentile, MS
• Jessica Hartigan, M.S. CCC-SLP
• Nathan Vincent Hem, PA
• Gerri Hoegler, LPC
• Michelle Holler
• Karen Cooney Holistic Health LLC

• Speech-Language Pathologist in West Creek, NJ
• Providers in West Creek, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.