Individual provider Active NPI

Brittaini Lanika Goettl

  • Wound Care Registered Nurse
  • Albany, OR
National Provider Identifier
1659845915
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
License
201506078RN Issued in OR
Practice address
840 Broadway St SW
Albany, OR 97321-2077
Phone
(541) 908-5701
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WW0000X 201506078RN OR Primary

Addresses

Primary practice location

840 Broadway St SW
Albany, OR 97321-2077

Mailing address

840 Broadway St SW
Albany, OR 97321-2077
Phone (541) 974-4517

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

LicenseStateTypeSpecialty
201506078RNORMDWound Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1659845915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 BROADWAY ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212077",
            "telephone_number": "541-974-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 BROADWAY ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212077",
            "telephone_number": "541-908-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTL",
        "first_name": "BRITTAINI",
        "middle_name": "LANIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": "OR",
            "license": "201506078RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.