Individual provider Active NPI

Adam Goodrich, LMT

  • Specialist
  • Marion, OH
National Provider Identifier
1083915946
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
33016201EG Issued in OH
Practice address
1050 Delaware Ave
Marion, OH 43302-6416
Phone
(740) 383-8055
NPI assigned
Nov 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 33016201EG OH Primary

Addresses

Primary practice location

1050 Delaware Ave
Marion, OH 43302-6416

Mailing address

PO Box 1827
Marion, OH 43301-1827
Phone (740) 383-8022

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

State licenses

LicenseStateTypeSpecialty
33016201EGOHMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1083915946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1827",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433011827",
            "telephone_number": "740-383-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 DELAWARE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026416",
            "telephone_number": "740-383-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "ADAM",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "33016201EG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.