Active NPI
Eric P B Goodspeed, D.O.
- Hospitalist Physician
- Fayetteville, AR
National Provider Identifier
1003923715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- E-6590
- Practice address
- 3215 N Northhills Blvd
Fayetteville, AR 72703-4424 - Phone
- (479) 463-7102
- Fax
- (479) 463-7864
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E6590 | AR | |
| General Practice Physician | 208D00000X | 487 | NE | |
| Hospitalist Physician | 208M00000X | E-6590 | AR | Primary |
Addresses
Primary practice location
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Mailing address
12 East Appleby Road
Fayetteville, AR 72703
Phone (479) 463-7102
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E6590 | AR | MD | Family Medicine Physician |
| 487 | NE | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1003923715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 EAST APPLEBY ROAD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-463-7102",
"fax_number": "479-463-7864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3215 N NORTHHILLS BLVD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034424",
"telephone_number": "479-463-7102",
"fax_number": "479-463-7864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSPEED",
"first_name": "ERIC",
"middle_name": "P B",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E6590",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NE",
"license": "487",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AR",
"license": "E-6590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.