Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Adam Brock Goforth

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1356173124

Adam Brock Goforth is a Nurse Practitioner in Anna, Illinois. Qualified in 2024, 2 years ago. Practices with Rural Health, Inc, a 16-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2024
Specialties on file
2

Practice location Address checks out

513 N Main St
Anna, IL 62906-1697
Phone: (618) 833-4471
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209.030398 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 041.505508 (IL)

Record details

NPI number1356173124
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 19, 2024
Last updated in NPPESDecember 9, 2024
Certification dateNovember 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Rural Health, Inc. — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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