JEFFREY GOODFELLOW (NPI# 1972980985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972980985 |
| Entity Type | Individual |
| Full Name | JEFFREY GOODFELLOW |
| Credential | R.N. |
| Practice Address |
480 Galletti Way Sparks NV 89431-5564 |
| Practice Telephone | 7756882001 |
| Practice Fax Number | 7756882004 |
| Mailing Telephone | 7756882001 |
| Mailing Fax Number | 7756882004 |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
RN33445 | NV | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | RN LICENSE NUMBER | RN33445 | 01 |
| Street Address |
480 GALLETTI WAY |
| City | SPARKS |
| State | NV |
| Zip Code | 89431-5564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972501021 | State of Nevada | Psychiatric Hospital | 480 Galletti Way, Sparks, NV 89431-5564 | 2005-07-12 |
| 1760022214 | Dr. William Jackson | Clinic/Center | 480 Galletti Way, Sparks, NV 89431-5564 | 2020-01-13 |
| 1124676614 | Bryon Jason Gallant | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2019-08-28 |
| 1063076578 | David R Ball | Day Training/Habilitation Specialist | 480 Galletti Way, Sparks, NV 89431-5564 | 2019-04-30 |
| 1154893980 | Juan Manuel Juarez Jr. | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-12-18 |
| 1861962805 | Ange Kay Zimmerman | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-12-03 |
| 1053887588 | Richard Alexander Noack | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-10-23 |
| 1053886739 | Jessica Kate Ketz | Case Manager/Care Coordinator | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-10-09 |
| 1720563497 | Colleen Patricia Haesche | Case Manager/Care Coordinator | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-09-28 |
| 1457839797 | Mitchell Stuart Lasco | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053958033 | Jerome Johnson II | Behavioral Analyst | 3115 Saltern Way, Sparks, NV 89431 | 2019-12-09 |
| 1528520640 | Dynisha Bernee Richardson | Technician, Other | 616 Victorian Ave, Sparks, NV 89431 | 2019-04-05 |
| 1902376494 | Avalon Care Center-va Reno, LLC | Skilled Nursing Facility | 36 Battle Born Way, Sparks, NV 89431 | 2018-11-28 |
| 1669964128 | Abraham A Arellano | Behavioral Analyst | 2005 Probasco Way, Sparks, NV 89431 | 2018-05-31 |
| 1003335399 | Carresa Greer | Counselor | 390 Freeport Blvd #3, Sparks, NV 89431 | 2017-09-18 |
| 1689197444 | Fred Blauth Jr. | Counselor | 2105 Sullivan Ln, Sparks, NV 89431 | 2017-07-24 |
| 1548719255 | Adolescent Treatment Center | Community Based Residential Treatment Facility, Mental Illness | 480 Galetti Way, Sparks, NV 89431 | 2016-09-23 |
| 1124478862 | Kristina Schneider | Behavioral Analyst | 3230 Wedekind Rd, 50, Sparks, NV 89431 | 2016-06-14 |
| 1336506898 | Rikki Texter | Occupational Therapy Assistant | 1025 Robert Lane, Sparks, NV 89431 | 2016-01-28 |
| 1851760177 | Elizabeth Ojeda | Counselor | 490 Galletti Way, Building 8c, Sparks, NV 89431 | 2015-09-16 |
| Find all providers in zip 89431 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023279833 | Jeanine P Paul | Registered Nurse | 480 Galletti Way Bldg 25, Room #406, Sparks, NV 89431-5564 | 2008-06-24 |
| 1407208184 | Terra Moser | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2016-07-06 |
| 1669840294 | Lynette Rachele Langguth | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2015-09-14 |
| 1659748283 | Jasmine Jadena Lowder | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2015-08-31 |
| 1275911299 | Lisa Barnum | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2015-05-11 |
| 1831588987 | Zalei Lewis | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2015-01-13 |
| 1518365592 | Jeffrey Cunanan Acosta | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2014-12-08 |
| 1801299771 | Cheryl Dressler | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2014-10-06 |
| 1952710964 | Sandra Lee Benedict | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2014-08-05 |
| 1033528005 | Susan Lee Mcclure | Registered Nurse | 480 Galletti Way, Sparks, NV 89431-5564 | 2014-08-04 |
| Find all providers in SPARKS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.