Individual provider Active NPI

Heather Goodly, M.D.

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1013351832
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
58860 Issued in AZ
Practice address
645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351
Phone
(602) 262-8900
Fax
(602) 262-8890
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD188830 OR
Anesthesiology Physician 207L00000X 58860 AZ Primary

Addresses

Primary practice location

645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351

Mailing address

645 E Missouri Ave Ste 300
Phoenix, AZ 85012-1351
Phone (602) 262-8900

Other practice location 1

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-3154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190917003320 AZ Practitioner - Anesthesiology 8527315324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

1500 S Dobson Rd
Suite 101
Mesa, AZ 85202-4722
Phone (480) 412-3577

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5555

9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone (623) 327-5047

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
  • Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58860AZMDAnesthesiology Physician
MD188830ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Aug 1, 2019 Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

9301 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 213-7407

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

3535 N Scottsdale Rd
Scottsdale, AZ 85251
Phone (480) 675-4657

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1013351832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-222-3154",
            "fax_number": "541-222-3359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODLY",
        "first_name": "HEATHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD188830",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "58860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.