Elaine Goodman

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

R3658 Issued in MD

Practice address

13 Breezy CT
Reisterstown, MD 21136-3532

Phone

(410) 902-6540

Fax

(410) 902-6071

NPI assigned

Jun 13, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chesapeake Medcare Services, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Reisterstown, MD
  • NPI 1639534712
  NPD (past) Authorized official

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1073927372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 BREEZY CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363532",
            "telephone_number": "410-902-6540",
            "fax_number": "410-902-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 BREEZY CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363532",
            "telephone_number": "410-902-6540",
            "fax_number": "410-902-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R3658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID #",
            "identifier": "521608273",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Joy Goldberg, DDS
• Golden Life Standard Health LLC
• Nathan Goldentayer, PHARMD
• Kariza Gomes Goncalves
• Carines Paola Gonzalez Reyes
• Gracious Health Services
• Wendie Katrina Grader-Beck, M.D.
• Alex Graff
• Shemika Ariel Graham, CNA-DT
• Great Works Wellness Center

• Durable Medical Equipment & Medical Supplies in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Durable Medical Equipment & Medical Supplies in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.