Individual provider Active NPI

Samuel Goetschius, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1932505054
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
76527 Issued in KS
Practice address
7300 W 110TH St Ste 700
Overland Park, KS 66210-2332
Phone
(620) 704-0224
NPI assigned
Nov 17, 2014
Last updated
Dec 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-76527-011 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 76527 KS Primary

Addresses

Primary practice location

7300 W 110TH St Ste 700
Overland Park, KS 66210-2332

Mailing address

3311 Yellowstar St
Garden City, KS 67846-6992
Phone (913) 295-0501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20150501000713 KS Practitioner - Nurse Practitioner 1850618612 Practice locations: Overland Park, KS

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-76527-011KSMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1932505054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 YELLOWSTAR ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466992",
            "telephone_number": "913-295-0501",
            "fax_number": "620-634-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W 110TH ST STE 700",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102332",
            "telephone_number": "620-704-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETSCHIUS",
        "first_name": "SAMUEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-17",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76527-011",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "76527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.