Individual provider Active NPI

Cacie Lee Goetz-Campos, MSN, FNP-C

  • Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1700537321
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
268788 Issued in AZ
Practice address
830 Ainsworth Dr
Prescott, AZ 86301-1630
Phone
(928) 777-5800
Fax
(928) 776-0405
NPI assigned
Jan 14, 2022
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 268788 AZ Primary
Family Nurse Practitioner 363LF0000X 268788 AZ

Addresses

Primary practice location

830 Ainsworth Dr
Prescott, AZ 86301-1630

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

820 Ainsworth Dr Ste B
Prescott, AZ 86301-1613
Phone (928) 777-5810

Other practice location 2

2820 N Glassford Hill Rd Ste 103
Prescott Valley, AZ 86314-2256
Phone (928) 772-8553

Other practice location 3

2820 N Glassford Hill Rd Ste 107
Prescott Valley, AZ 86314-2256
Phone (928) 772-8553

Other practice location 4

203 S Candy Ln Ste 14
Cottonwood, AZ 86326-4120
Phone (928) 639-3387

Other practice location 5

820 Ainsworth Dr Ste A
Prescott, AZ 86301-1613
Phone (928) 777-5800

Other identifiers 1

IdentifierTypeStateIssuer
123639MedicaidAZ

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address Cacie.GoetzCampos@forefrontdermatology.emadirect.md
Direct Messaging Address Cacie.GoetzCampos@forefrontdermatology.emadirect.md
Direct Messaging Address Cacie.GoetzCampos@forefrontdermatology.emadirect.md
Direct Messaging Address Cacie.GoetzCampos@forefrontdermatology.emadirect.md
Direct Messaging Address Cacie.GoetzCampos@forefrontdermatology.emadirect.md
Direct Messaging Address Cacie.GoetzCampos@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220215002166 AZ Practitioner - Nurse Practitioner 0648663609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

830 Ainsworth Dr
Prescott, AZ 86301-1630
Phone (928) 777-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
268788AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Jan 3, 2022 Accepting new patients
Yavapai Family Medical PLLC Family CurrentSince Jun 5, 2023 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Jan 3, 2022 Accepting new patients
Forefront Dermatology, S.C. Current Accepting new patients
Arizona Associates in Dermatology and Cosmetic Surgery, LLC Current Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients

Locations

875 N Greenfield Rd
Ste 108
Gilbert, AZ 85234
Phone (480) 553-7993

2501 N Stockton Hill Rd
Ste 108
Kingman, AZ 86401
Phone (928) 255-5050

820 Ainsworth Dr
Ste A
Prescott, AZ 86301
Phone (928) 777-5800

820 Ainsworth Dr
Ste B
Prescott, AZ 86301
Phone (928) 541-1312

830 Ainsworth Dr
Prescott, AZ 86301
Phone (928) 202-4143

2820 N Glassford Hill Rd
Ste 103
Prescott Vly, AZ 86314
Phone (928) 772-8553

2820 N Glassford Hill Rd
Ste 107
Prescott Vly, AZ 86314
Phone (928) 772-8553

7750 E Florentine Rd
#A
Prescott Vly, AZ 86314
Phone (928) 277-1211

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: cacie.goetzcampos@forefrontdermatology.emadirect.md
  • FHIR API: https://api.platform.athenahealth.com/26248/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1700537321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 AINSWORTH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011630",
            "telephone_number": "928-777-5800",
            "fax_number": "928-776-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Ainsworth Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863011613",
            "country_code": "US",
            "telephone_number": "928-777-5810",
            "fax_number": "928-776-0405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 N Glassford Hill Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142256",
            "country_code": "US",
            "telephone_number": "928-772-8553",
            "fax_number": "928-776-0405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 N Glassford Hill Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142256",
            "country_code": "US",
            "telephone_number": "928-772-8553",
            "fax_number": "928-776-0405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "203 S Candy Ln Ste 14",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863264120",
            "country_code": "US",
            "telephone_number": "928-639-3387",
            "fax_number": "928-634-0311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Ainsworth Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863011613",
            "country_code": "US",
            "telephone_number": "928-777-5800",
            "fax_number": "928-776-0405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOETZ-CAMPOS",
        "first_name": "CACIE",
        "middle_name": "LEE",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "268788",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "268788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123639",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cacie.GoetzCampos@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "203 S Candy Ln Ste 14",
            "city": "Cottonwood",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863264120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cacie.GoetzCampos@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "820 Ainsworth Dr Ste B",
            "city": "Prescott",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863011613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cacie.GoetzCampos@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "820 Ainsworth Dr Ste A",
            "city": "Prescott",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863011613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cacie.GoetzCampos@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2820 N Glassford Hill Rd Ste 107",
            "city": "Prescott Valley",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863142256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cacie.GoetzCampos@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "830 Ainsworth Dr",
            "city": "Prescott",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863011630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cacie.GoetzCampos@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2820 N Glassford Hill Rd Ste 103",
            "city": "Prescott Valley",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863142256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.