Adam Brock Goforth, - Medicare Nurse Practitioner in Anna, IL

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Adam Brock Goforth, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Anna, Illinois. His current practice location is 513 N Main St, Anna, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 833-4471.

Adam Brock Goforth is licensed to practice in Illinois (license number 209.030398) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356173124.

Contact Information

Adam Brock Goforth,
513 N Main St,
Anna, IL 62906-1697
(618) 833-4471
Not Available

Map and Direction




Provider's Profile

Full NameAdam Brock Goforth
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location513 N Main St, Anna, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1356173124
  • Provider Enumeration Date: 08/19/2024
  • Last Update Date: 12/09/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8325570104
  • Enrollment ID: I20241017003122

Medical Identifiers

Medical identifiers for Adam Brock Goforth such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356173124NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 209.030398 (Illinois)Primary
163W00000XRegistered Nurse 041.505508 (Illinois)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Adam Brock Goforth allows following entities to bill medicare on his behalf.
Entity NameRural Health, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982666384
PECOS PAC ID: 6800705427
Enrollment ID: O20040518000240

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Adam Brock Goforth is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Adam Brock Goforth,
513 N Main St,
Anna, IL 62906-1668

Ph: () -		Adam Brock Goforth,
513 N Main St,
Anna, IL 62906-1697

Ph: (618) 833-4471

Reviews and Comments


Nurse Practitioner Nurses in Anna, IL

Mrs. Cassy A Coleman,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 517 N Main St, Anna, IL 62906
Phone: 618-833-4511    
Ms. Heather Dawn Davis, APRN,FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1000 N Main St, Anna, IL 62906
Phone: 618-833-5161    Fax: 618-833-9034
Keith Samuel Bass, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 513 N Main St, Anna, IL 62906
Phone: 618-833-4471    
Jessica Elizabeth Wills, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 513 N Main St, Anna, IL 62906
Phone: 618-833-4471    Fax: 618-833-6267
Ms. Erica Vining, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 513 N Main St, Anna, IL 62906
Phone: 618-833-4471    
Rebecca L Pind, APN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 517 N Main St, Anna, IL 62906
Phone: 618-833-2295    Fax: 618-833-9058

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.