Goodwill of the Great Plains

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

ADS005 Issued in IA

Legal business name

GOODWILL OF THE GREAT PLAINS

Practice address

3100 W 4TH St
Sioux City, IA 51103-3202

Phone

(712) 258-4511

Fax

(712) 258-7832

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Shawn C Fick

Title

Vice President Mission Advancement

Phone

(712) 258-4511

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 2

• Goodwill Industries Doing business as
• Wall Street Mission Former legal business name

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1750439501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W 4TH ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511033202",
            "telephone_number": "712-258-4511",
            "fax_number": "712-258-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W 4TH ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511033202",
            "telephone_number": "712-258-4511",
            "fax_number": "712-258-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL OF THE GREAT PLAINS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "FICK",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT MISSION ADVANCEMENT",
        "authorized_official_telephone_number": "712-258-4511"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "IA",
            "license": "ADS005",
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082081",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236539",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodwill Industries",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wall Street Mission",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Angela Goergen, LPN
• Alma Delia Gonzalez, CADC
• Roy Gonzalez, PTA
• Marion Steve Goodon Jr., IADC
• Leslie A Goodrich, LISW CADC SOTP I
• Carolyn Goodwin, CADC
• Adam Scott Gordon, MD
• Janene Gorsett
• Jamee Goslar, RPH
• Christina Grabouski, CRNA

• Voluntary or Charitable Agency in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Voluntary or Charitable Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.