HALEY NICHOLE GOODFELLOW (RD, LDN) – Registered Dietitian, NPI 1952929283

HALEY NICHOLE GOODFELLOW (RD, LDN) is a healthcare provider. based in Columbia, Illinois. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD, LDN. They hold a License No. 2020013164 (MO). The NPI Number for HALEY NICHOLE GOODFELLOW (RD, LDN) is 1952929283

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
HALEY NICHOLE GOODFELLOW (RD, LDN)
NPI
1952929283
Phone
(618) 531-6029
Address
213 LONGVIEW DR
Enumeration Date
13 July 2020
Last Update Date
13 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5126937045
Graduation Year
2019 (7 years ago)
PAC ID
4688012420
Group Practice PAC ID
1557724937
Professional Enrollment ID
I20240329001502
Address ID
TX787316204AU3724XSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

311 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in IL

Provider Addresses for HALEY NICHOLE GOODFELLOW (RD, LDN)

  • 213 LONGVIEW DR

    COLUMBIA, IL 622362079

    Phone: (618) 531-6029

    Type: Mailing

  • 60 S STATE ROUTE 157

    EDWARDSVILLE, IL 620253846

    Phone: (618) 655-8147

    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: 2024-03-29

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
I20240329001502IRegistered Dietitian Or Nutrition ProfessionalTXTBD

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 62236)

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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: 1557724937View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalNC
Registered Dietitian Or Nutrition ProfessionalCA
Registered Dietitian Or Nutrition ProfessionalTX
Registered Dietitian Or Nutrition ProfessionalKY
Registered Dietitian Or Nutrition ProfessionalSC
Registered Dietitian Or Nutrition ProfessionalPA
Registered Dietitian Or Nutrition ProfessionalVA
Registered Dietitian Or Nutrition ProfessionalGA
Registered Dietitian Or Nutrition ProfessionalMS
Registered Dietitian Or Nutrition ProfessionalMI

Reviews

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Frequently asked questions

What unique ID ties claims to HALEY NICHOLE GOODFELLOW (RD, LDN)?
NPI 1952929283 is assigned to HALEY NICHOLE GOODFELLOW (RD, LDN) under the national enumeration system.
Is HALEY NICHOLE GOODFELLOW (RD, LDN) currently active in the NPI registry?
CMS-published data lists HALEY NICHOLE GOODFELLOW (RD, LDN) as an active registrant.
Does HALEY NICHOLE GOODFELLOW (RD, LDN) list a primary specialty?
If you are matching referrals, note Registered Dietitian for HALEY NICHOLE GOODFELLOW (RD, LDN). Clinical services aligned with this taxonomy classification.
Where does public data place HALEY NICHOLE GOODFELLOW (RD, LDN)?
The snapshot lists Columbia, Illinois for HALEY NICHOLE GOODFELLOW (RD, LDN); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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