Individual provider Active NPI

Samantha Kaye Goodlett, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Danville, KY
National Provider Identifier
1730850363
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3017050 Issued in KY
Practice address
120 Daniel Dr
Danville, KY 40422-2527
Phone
(859) 239-5570
NPI assigned
Sep 23, 2021
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3017050 KY Primary

Addresses

Primary practice location

120 Daniel Dr
Danville, KY 40422-2527

Mailing address

PO Box 990
Danville, KY 40423-0990
Phone (859) 239-2360

Other practice location 1

200 Belmont Ave
Somerset, KY 42501-2419
Phone (606) 687-2038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220304001266 KY Practitioner - Nurse Practitioner 0345634549 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

120 Daniel Dr
Danville, KY 40422-2527
Phone (859) 239-5570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.36 of 100Reported as group
Quality
64.78
Promoting interoperability
100
Improvement activities
40
Cost
67.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Counseling Ky Psychiatric/Mental Health CurrentSince Sep 28, 2021 Accepting new patients
Ephraim McDowell Health Resource, Inc CurrentSince Aug 24, 2022 Accepting new patients
Ephraim McDowell Health Resource, Inc Psychiatric/Mental Health CurrentSince Aug 24, 2022 Accepting new patients
Ephraim McDowell Health Resource, Inc. Current Accepting new patients

Locations

109 Daniel Dr
Danville, KY 40422
Phone (859) 236-3361

120 Daniel Dr
Danville, KY 40422
Phone (859) 236-0903

124 Daniel Dr
Danville, KY 40422
Phone (859) 239-5570

200 Belmont Ave
Somerset, KY 42501
Phone (606) 678-2038

Organizations & group practices 4

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 2

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1730850363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404230990",
            "telephone_number": "859-239-2360",
            "fax_number": "859-239-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DANIEL DR",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222527",
            "telephone_number": "859-239-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425012419",
            "country_code": "US",
            "telephone_number": "606-687-2038",
            "fax_number": "606-200-3654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODLETT",
        "first_name": "SAMANTHA",
        "middle_name": "KAYE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3017050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.