Individual provider Active NPI

Ann M. Goff, M.A., CCC-A

  • Audiologist
  • Tinley Park, IL
National Provider Identifier
1700021631
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147-000611 Issued in IL
Practice address
16532 Oak Park Ave
Ste 202
Tinley Park, IL 60477-1918
Phone
(708) 444-2900
Fax
(708) 444-7760
NPI assigned
Dec 5, 2008
Last updated
Dec 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002416A IN
Audiologist 231H00000X 147-000611 IL Primary

Addresses

Primary practice location

16532 Oak Park Ave
Ste 202
Tinley Park, IL 60477-1918

Mailing address

2606 Wallace Dr
Flossmoor, IL 60422-1238
Phone (708) 305-5121

Other identifiers 1

IdentifierTypeStateIssuer
326971OtherILINACTIVE MEDICARE NUMBER

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
147-000611ILMDAudiologist
23002416AINMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1700021631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 WALLACE DR",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221238",
            "telephone_number": "708-305-5121",
            "fax_number": "708-798-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16532 OAK PARK AVE",
            "address_2": "STE 202",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771918",
            "telephone_number": "708-444-2900",
            "fax_number": "708-444-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "ANN",
        "middle_name": "M.",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002416A",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-000611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INACTIVE MEDICARE NUMBER",
            "identifier": "326971",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.