Shanda L Goecks

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

190756 Issued in WI

Practice address

6916 26TH Ave
Kenosha, WI 53143

Phone

(262) 914-0081

NPI assigned

Oct 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1891262275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6916 26TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6916 26TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53143",
            "telephone_number": "262-914-0081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6916 26th ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "53143",
            "country_code": "US",
            "telephone_number": "262-914-0081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOECKS",
        "first_name": "SHANDA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "190756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Nicole Gittens
• Kristina M Gittens, NP
• Courtney Glassman
• Samantha Gleason, PT
• Shannon Godbolt, APNP
• Alline Goeke
• Steve Goldberg, LCSW
• Joshua Gomez, PTA
• Angela Gonzales
• Cesar D Gonzalez, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.