Individual provider Active NPI

Pamela S Goebel-Roberts, ARNP

  • Family Health Clinical Nurse Specialist
  • Derby, KS
National Provider Identifier
1669628087
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
13-87426-072 Issued in KS
Practice address
1720 E Osage Rd
Derby, KS 67037-2090
Phone
(316) 789-8222
Fax
(316) 651-2344
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X 13-87426-072 KS Primary

Addresses

Primary practice location

1720 E Osage Rd
Derby, KS 67037-2090

Mailing address

1720 E Osage Rd
Derby, KS 67037-2090
Phone (316) 789-8222

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13-87426-072KSMDFamily Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1669628087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E OSAGE RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372090",
            "telephone_number": "316-789-8222",
            "fax_number": "316-651-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E OSAGE RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372090",
            "telephone_number": "316-789-8222",
            "fax_number": "316-651-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEBEL-ROBERTS",
        "first_name": "PAMELA",
        "middle_name": "S",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "KS",
            "license": "13-87426-072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.