Active NPI
La-Dricka Chiree Goodman
- Case Manager/Care Coordinator
- Kissimmee, FL
National Provider Identifier
1780056515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1216 Patrick St
Kissimmee, FL 34741-5534 - Phone
- (321) 236-1540
- NPI assigned
- Oct 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1216 Patrick St
Kissimmee, FL 34741-5534
Mailing address
1216 Patrick St
Kissimmee, FL 34741-5534
Phone (321) 236-1540
Other practice location 1
2814 S US Highway 1
Suite D4
Fort Pierce, FL 34982-8120
Phone (772) 489-4726
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serving Children and Reaching Families | Current | Accepting new patients | |
| Suncoast Mental Health Center, Inc. | Past | Accepting new patients |
Locations
1216 Patrick St
Kissimmee, FL 34741
Phone (321) 236-1540
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Kissimmee, FL
- NPI 1336588813
-
- Community/Behavioral Health Agency
- Fort Pierce, FL
- NPI 1225046550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679961600000",
"number": "1780056515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 PATRICK ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415534",
"telephone_number": "321-236-1540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1216 PATRICK ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415534",
"telephone_number": "321-236-1540"
}
],
"practiceLocations": [
{
"address_1": "2814 S US Highway 1",
"address_2": "Suite D4",
"address_purpose": "LOCATION",
"city": "Fort Pierce",
"state": "FL",
"postal_code": "349828120",
"country_code": "US",
"telephone_number": "772-489-4726",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOODMAN",
"first_name": "LA-DRICKA",
"middle_name": "CHIREE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-20",
"last_updated": "2023-03-28",
"certification_date": "2023-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.