Tim Gooch, APRN
Individual provider Active NPI Family Nurse Practitioner · Harrodsburg, KY
NPI 1740635010 · NPPES record last updated May 7, 2024
Key facts
- NPI
- 1740635010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3010233 (KY)
- Practice address
- 1064 N College St
Harrodsburg, KY 40330-2208 - Phone
- (859) 734-3057
- Fax
- (502) 839-3806
- NPI assigned
- Apr 25, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spivey Medical, PLLC
Practice addresses (Care Compare)
1064 N College St
Harrodsburg, KY 40330-2208
Phone (859) 734-3057
1075 E Lexington Ave
Danville, KY 40422-1766
Phone (859) 712-2041
92 Plaza Dr
Lawrenceburg, KY 40342-9056
Phone (502) 839-3805
Hospital & facility affiliations
- The James B. Haggin Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161122000109 | KY | Practitioner - Nurse Practitioner | 8729367438 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3010233 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lexington Urgent Care PLLC | Current |
Accepting new patients | |
| Georgetown Urgent Care PLLC | Current |
Accepting new patients | |
| Real Health Primary Care LLC | Family | Current |
Accepting new patients |
| Fast Pace Kentucky PLLC | Current |
Accepting new patients | |
| Isaiah House, Inc. | Current |
Accepting new patients | |
| Spivey Medical, PLLC | Current |
Accepting new patients | |
| Brock Medical, LLC | Current |
Accepting new patients |
Locations
100 Broadway
Ste 101
Chaplin, KY 40012
975 Hustonville Rd
Ste 9
Danville, KY 40422
Phone (859) 209-2331
111 Osborne Way
#101
Georgetown, KY 40324
Phone (859) 466-8956
1064 N College St
Harrodsburg, KY 40330
Phone (859) 734-3004
92 Plaza Dr
Lawrenceburg, KY 40342
Phone (502) 839-3805
1701 Nicholasville Rd
Ste 100
Lexington, KY 40503
Phone (859) 466-8956
1701 Nicholasville Rd
Lexington, KY 40503
Phone (859) 278-9373
1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055
2084 Main St
Willisburg, KY 40078
Interoperability endpoints
- timothy.gooch.1@22146.direct.athenahealth.com
- https://api.platform.athenahealth.com/22146/brand/1/csg/1/fhir/r4
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3010233 | KY | Yes |
Addresses
Primary practice location
1064 N College St
Harrodsburg, KY 40330-2208
Mailing address
92 Plaza Dr
Lawrenceburg, KY 40342-9056
Phone (859) 319-8487
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100450400 | Medicaid | KY |
Other providers in Harrodsburg, KY
- Patricia R Freeman
- Mary N. Fuller
- Natalie Gabbard
- Sandra Geile
- Marjorie Gill
- Mary Kathryn Goodlett
- Heather R Goodman
- Robert I. Goodman Jr.
- Jack B Gross
- Janice Gross
All providers in Harrodsburg, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.