STANLEY GOODING FNP NPI 1679019400

NPI Information

NPI: 1679019400
Provider Name: STANLEY GOODING, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
5520 GODFREY RD
STE B
GODFREY, IL
ZIP 62035
Phone: (618) 463-7800
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Stanley Gooding, FNP is a family nurse practitioner in Godfrey, IL. Stanley Gooding, FNP NPI is 1679019400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5520 GODFREY RD
STE B
GODFREY, IL
ZIP 62035-741
Phone: (618) 463-7800
Fax: (618) 467-0073

The NPI 1679019400 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/18/2017 and was last updated on 4/5/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		2017001791	MISSOURI	No
2	163W00000X	Registered Nurse		131063	MISSOURI	No
3	363LF0000X	Nurse Practitioner	Family	2017001791	MISSOURI	No
4	363LF0000X	Nurse Practitioner	Family	209015670	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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