Thara Gopinathan, AGPCNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

11012036 Issued in FL

Practice address

701 Union St
Kissimmee, FL 34741-5007

Phone

(407) 952-3242

NPI assigned

Mar 9, 2021

Last updated

Nov 27, 2021By 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 2

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": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637971200000",
    "number": "1902481161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13527 BUDWORTH CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326111",
            "telephone_number": "407-952-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNION ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415007",
            "telephone_number": "407-952-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPINATHAN",
        "first_name": "THARA",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-11-27",
        "certification_date": "2021-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11012036",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11012036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La-Dricka Chiree Goodman
• Pamela Goodridge
• Kenaya Tori Goods-Onyango, LPN
• Aaryka Goodwell
• Kenesha S Gopaul
• Amber Lynn Gordon
• Carissa Nichole Gordon, RBT
• Darlene Gordon, NURSE PRACTITIONER
• James D Gordon, MD
• Sarah Michelle Gordon

• Gerontology Nurse Practitioner in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2021; 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.