Individual provider Active NPI

Matthew S Gooch, CNP

  • Nurse Practitioner
  • Alliance, OH
National Provider Identifier
1881007706
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15946-NP Issued in OH
Practice address
1207 W State St
Suite N
Alliance, OH 44601-4686
Phone
(330) 821-3244
Fax
(330) 680-4110
NPI assigned
Jun 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15946-NP OH Primary

Addresses

Primary practice location

1207 W State St
Suite N
Alliance, OH 44601-4686

Mailing address

1207 W State St
Suite N
Alliance, OH 44601-4686
Phone (330) 821-3244

Other identifiers 1

IdentifierTypeStateIssuer
0105804MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140623002421 OH Practitioner - Nurse Practitioner 9335363845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manor Management Company IncGroup PAC ID 7012911209, 7 clinicians

Practice addresses (Care Compare)

1168 Alliance Rd NW
Minerva, OH 44657-8736
Phone (330) 868-3711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15946-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Manor Management Company Inc CurrentSince Jun 5, 2014 Accepting new patients
Neurocare Sleep Center Past Accepting new patients

Locations

1207 W State St
Ste N
Alliance, OH 44601
Phone (330) 821-3244

4080 Holiday St NW
Canton, OH 44718
Phone (330) 492-8117

1168 Alliance Rd NW
Minerva, OH 44657
Phone (330) 868-3711

Interoperability endpoints

  • Direct secure messaging: matthew.gooch.1@2706.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/2706/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/22081/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 4

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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1881007706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST",
            "address_2": "SUITE N",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-3244",
            "fax_number": "330-680-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST",
            "address_2": "SUITE N",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-3244",
            "fax_number": "330-680-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2023-06-20",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "15946-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.