KRISTY DIANE GOODSON – Mental Health Counselor, NPI 1194156216

KRISTY DIANE GOODSON is a healthcare provider. based in Rexburg, Idaho. specializing in CLINICAL SOCIAL WORKER. They hold a License No. LCSW-38393 (ID). The NPI Number for KRISTY DIANE GOODSON is 1194156216

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
KRISTY DIANE GOODSON
NPI
1194156216
Phone
(208) 351-4643
Address
337 W 1ST N APT B
Enumeration Date
30 November 2013
Last Update Date
2 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2085235319
Graduation Year
2013 (13 years ago)
PAC ID
2163765942
Group Practice PAC ID
4688027188
Professional Enrollment ID
I20190517001629
Address ID
ID834064718AM1675XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

633 CLINICAL SOCIAL WORKER in ID

Provider Addresses for KRISTY DIANE GOODSON

  • 337 W 1ST N APT B

    REXBURG, ID 834401403

    Phone: (208) 351-4643

    Type: Mailing

  • PO BOX 2106

    IDAHO FALLS, ID 834032106

    Phone: (208) 523-5319

    Type: Mailing

  • 1675 CURLEW DR

    AMMON, ID 834064718

    Phone: (208) 523-5319

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190517001629IClinical Social WorkerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83440)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688027188View full group profile
NameSpecialtyState
Clinical Social WorkerID
Clinical Social WorkerID
Clinical Social WorkerID
Mental Health CounselorID
Clinical Social WorkerID
Nurse PractitionerID
Clinical Social WorkerID
Nurse PractitionerID
Clinical Social WorkerID
Clinical Social WorkerID

Reviews

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Frequently asked questions

What is the registry number for KRISTY DIANE GOODSON?
The registry entry for KRISTY DIANE GOODSON shows NPI 1194156216.
Is KRISTY DIANE GOODSON's NPI status active today?
Active status means KRISTY DIANE GOODSON's NPI record is not deactivated in the public file.
Which specialty label fits KRISTY DIANE GOODSON?
NPPES ties KRISTY DIANE GOODSON to Mental Health Counselor in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is KRISTY DIANE GOODSON tied to Rexburg, Idaho?
If you are local to Rexburg, Idaho, KRISTY DIANE GOODSON may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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