Mark A Goforth, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP4993 Issued in AZ

Practice address

14029 E Camino Galante
Vail, AZ 85641-2067

Phone

(520) 904-7987

NPI assigned

Jan 27, 2014

Last updated

Aug 26, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mark A Goforth Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Connections Southernaz, LLC

  dba CRC-Outpatient Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1982362943
  Medicare reassignment NPD
• East Valley Psychiatry LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1992240857
  Medicare reassignment NPD
• Bloom Med, LLC

  • Health Service Clinic/Center
  • Chandler, AZ
  • NPI 1447140504
  Authorized official Same address or phone
• Connections Southernaz, LLC

  dba Crisis Response Center

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1871203463
  NPD
• Arc Medical Clinic

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1629798376
  NPD (past)

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1699198747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14029 E. CAMINO GALANTE",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "85641",
            "telephone_number": "520-904-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14029 E CAMINO GALANTE",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856412067",
            "telephone_number": "520-904-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFORTH",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "GOFORTH",
            "middle_name": "A",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Lynn Garcia, COTA
• Anne Hayes Getty, PMHNP
• Lisa Robin Glass, NURSE PRACTITIONER
• Glorious Therapy Services LLC
• Adam Robert Godfrey, SSP, NASP
• Sussan Lee Goldsworthy, DNP, PMHNP-BC
• Isabel Gomez, PTA
• Janalee Gordon, M.D.
• Betty Grant, RN 156773
• Melissa Amber Gummo, PMHNP-BC

• Psychiatric/Mental Health Nurse Practitioner in Vail, AZ
• Providers in Vail, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.