Active NPI
Amy Lee Goedecke, RN,MSN,FNP-C
- Family Nurse Practitioner
- Whitesboro, TX
National Provider Identifier
1952776890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP129412
- Practice address
- 401 E Main St
Whitesboro, TX 76273-1805 - Phone
- (903) 564-7709
- Fax
- (903) 564-7090
- NPI assigned
- Dec 3, 2015
- Last updated
- Dec 3, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP129412 | TX | Primary |
| Family Nurse Practitioner | 363LF0000X | 87252 | OK |
Addresses
Primary practice location
401 E Main St
Whitesboro, TX 76273-1805
Mailing address
401 E Main St
Whitesboro, TX 76273-1805
Phone (903) 564-7709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
714 E Hwy 70
Kingston, OK 73439-8252
714 Hwy 70 E
Kingston, OK 73439-8252
Phone (580) 564-0200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Family Medicine | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients | |
| A.L.L. Care Home Services Inc. | Past | Accepting new patients | |
| Pilot Point Home Health Inc. | Past | Accepting new patients | |
| Lakeside Family Medicine | Past | Accepting new patients |
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Pilot Point Home Health Inc. | Home health agency | 5% Or Greater Direct Ownership Interest Corporate Officer W-2 Managing Employee Operational/Managerial Control |
Jun 1, 1992 Jun 1, 1992 Jun 1, 1992 Jun 1, 1992 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Whitesboro, TX
- NPI 1497772289
5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Kingston, OK
- NPI 1295064178
-
- Home Health Agency
- Whitesboro, TX
- NPI 1497772289
-
- Home Health Agency
- Whitesboro, TX
- NPI 1447655790
-
- Family Medicine Physician
- Kingston, OK
- NPI 1790188639
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Tishomingo, OK
- NPI 1891116232
-
dba AllianceHealth Madill
- Critical Access Hospital
- Madill, OK
- NPI 1467476556
-
- Home Health Agency
- Madill, OK
- NPI 1417974296
-
- General Acute Care Hospital
- Ardmore, OK
- NPI 1386741635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449100800000",
"number": "1952776890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E MAIN ST",
"city": "WHITESBORO",
"state": "TX",
"postal_code": "762731805",
"telephone_number": "903-564-7709",
"fax_number": "903-564-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E MAIN ST",
"city": "WHITESBORO",
"state": "TX",
"postal_code": "762731805",
"telephone_number": "903-564-7709",
"fax_number": "903-564-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEDECKE",
"first_name": "AMY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "RN,MSN,FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-03",
"last_updated": "2015-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP129412",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "87252",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitesboro, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.