Carole Elaine Gooch, APRN,BC is a medicare enrolled "Nurse Practitioner" in Kingston, Georgia. Her current practice location is
30 Ward Mountain Rd, Kingston, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 266-4387.
Carole Elaine Gooch is licensed to practice in Georgia (license number RN069392) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578777967.
Provider's Profile
| Full Name | Carole Elaine Gooch |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 30 Ward Mountain Rd, Kingston, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578777967
- Provider Enumeration Date: 05/09/2007
- Last Update Date: 03/07/2011
Medicare PECOS Information:
- PECOS PAC ID: 1759443385
- Enrollment ID: I20081216000440
Medical Identifiers
Medical identifiers for Carole Elaine Gooch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578777967 | NPI | - | NPPES |
| LIC # | Other | GA | RN069392 |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | RN069392 (Georgia) | Primary |
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. Carole Elaine Gooch allows following entities to bill medicare on her behalf.
| Entity Name | House Calls Of Nw Georgia, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073774105
PECOS PAC ID: 8729140355
Enrollment ID: O20081216000502 |
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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. Carole Elaine Gooch 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 Address | Practice Location Address |
|---|
Carole Elaine Gooch, APRN,BC
30 Ward Mountain Rd,
Kingston, GA 30145-1129
Ph: (706) 266-4387 | Carole Elaine Gooch, APRN,BC
30 Ward Mountain Rd,
Kingston, GA 30145-1129
Ph: (706) 266-4387 |
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