JEROME GOOSSEN (NPI# 1336642438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336642438 |
| Entity Type | Individual |
| Full Name | JEROME GOOSSEN |
| Practice Address |
1295 Hazelwood St Boulder City NV 89005-2013 |
| Practice Telephone | 7022930143 |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 372500000X | Chore Provider | NV | Nursing Service Related Providers | |
| N | 372600000X | Adult Companion | NV | Nursing Service Related Providers | |
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
NV | Nursing Service Related Providers | |
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
NV | Nursing Service Related Providers | |
| N | 376J00000X | Homemaker | NV | Nursing Service Related Providers |
| Street Address |
1295 HAZELWOOD ST |
| City | BOULDER CITY |
| State | NV |
| Zip Code | 89005-2013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336763119 | Hitesh R Amin | Pharmacist | Sav-on Pharmacy, 1008 Nevada Way, Boulder City, NV 89005 | 2020-06-08 |
| 1871013086 | Wesley King | Rehabilitation Practitioner | 200 Wilson Circle, Boulder, NV 89005 | 2017-06-20 |
| 1568998714 | Bailey Godfrey | Registered Nurse | 1401 Pueblo Drive, Boulder City, NV 89005 | 2017-05-10 |
| 1972970127 | Elizabeth Anne Jones | Counselor | 202 Rainier Court, Boulder City, NV 89005 | 2015-08-24 |
| 1871913855 | Joy Reynolds | Rehabilitation Practitioner | 100 St. Jude's Street, Boulder City, NV 89005 | 2014-04-17 |
| 1710222815 | Laura Lynn Rivera | Counselor | 200 Wilson Cir, Boulder City, NV 89005 | 2012-11-30 |
| 1467723528 | Sandra Lee Miller | Community Health Worker | 659 Ave. H, Boulder City, NV 89005 | 2012-01-21 |
| 1689959272 | Eliscia Wight | Pharmacist | 101 E. Lake Mead Pkwy, Henderson, NV 89005 | 2011-10-15 |
| 1285876706 | National Park Service | Ambulance | 601 Nevada Hwy, Boulder City, NV 89005 | 2009-03-30 |
| 1861614679 | Rickey L. Smith | Pharmacist | 1008 Nevada Highway, Boulder City, NV 89005 | 2007-05-02 |
| Find all providers in zip 89005 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396628 | Jill Azevedo | Technician | 6300 Black Mesa Ct, Las Vegas, NV 89142-7919 | 2020-11-06 |
| 1861093072 | Nakia T Newson | Technician | 3033 Little Crimson Ave, North Las Vegas, NV 89081-6584 | 2020-11-04 |
| 1396346409 | Johanna Dwyer | Technician | 5755 E Lake Mead Blvd Apt D, Las Vegas, NV 89156-6859 | 2020-11-04 |
| 1063013274 | Lloyd Major | Technician | 3830 University Center Dr Apt 318, Las Vegas, NV 89119-7420 | 2020-11-04 |
| 1861093239 | Raiquave Morgan | Technician | 5256 Tamarus St Apt B, Las Vegas, NV 89119-5047 | 2020-11-03 |
| 1669073250 | Chrissy Bowser | Technician | 3355 Spg Mnt Rd Ste 67, Las Vegas, NV 89102-8633 | 2020-11-02 |
| 1235739392 | Maxima Del Carmen Garcia | Technician | 3580 E Alexander Rd Apt 2016, Las Vegas, NV 89115 | 2020-10-28 |
| 1427657196 | Hector Querubin | Technician | 5400 S Maryland Pkwy Apt 165, Las Vegas, NV 89119-2642 | 2020-10-22 |
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1881293777 | Miguel Angel Umpierre | Technician | 9889 Overlook Ridge Ave, Las Vegas, NV 89148 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | BOULDER CITY |
| Zip Code | 89005 |
Please comment or provide details below to improve the information on JEROME GOOSSEN.
| 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.