Kelli Ann Goodsir, RN BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

91209 Issued in WI

Practice address

530 E Ellendale Rd Unit 229
Edgerton, WI 53534-8474

Phone

(608) 289-2139

NPI assigned

Nov 5, 2019

Last updated

Jul 28, 2020By the provider in NPPES

Sex

Female

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

• Kelli Ann McNeil Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1740824572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E ELLENDALE RD UNIT 229",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535348474",
            "telephone_number": "608-289-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E ELLENDALE RD UNIT 229",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535348474",
            "telephone_number": "608-289-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSIR",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "91209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "MCNEIL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Brian Gibbs, PHARMD
• David P Gorski, PA-C
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• Jenna N Gresens, RPH
• William Gurske, CRNA

• Registered Nurse in Edgerton, WI
• Providers in Edgerton, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.