Individual provider Active NPI

David A Goodman, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bath, NY
National Provider Identifier
1003047077
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
051132-1 Issued in NY
Practice address
76 Veterans Ave
Pharmacy Dept (119)
Bath, NY 14810-0810
Phone
(607) 664-4469
Fax
(607) 664-4478
NPI assigned
Aug 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051132-1 NY Primary

Addresses

Primary practice location

76 Veterans Ave
Pharmacy Dept (119)
Bath, NY 14810-0810

Mailing address

76 Veterans Ave
Pharmacy Dept (119)
Bath, NY 14810-0810
Phone (607) 664-4469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051132-1NYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1003047077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "address_2": "PHARMACY DEPT (119)",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4469",
            "fax_number": "607-664-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "address_2": "PHARMACY DEPT (119)",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4469",
            "fax_number": "607-664-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "051132-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.