Goodman Medical Center PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GOODMAN MEDICAL CENTER PC

Practice address

715 State Route CC
Rolla, MO 65401-4402

Phone

(573) 308-5044

Fax

(573) 341-5300

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Karene Marie Goodman, NP

Title

Coowner

Phone

(573) 308-5044

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1104028489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654020918",
            "telephone_number": "573-308-5044",
            "fax_number": "573-341-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 STATE ROUTE CC",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014402",
            "telephone_number": "573-308-5044",
            "fax_number": "573-341-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODMAN MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "KARENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "573-308-5044",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500447206",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG5099",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priti Giri
• Mary Eleanor Givens, PHD
• Glenn a Kunkel MD LLC
• God Loves You Counseling LLC
• Gilda Haydee Gomez, M.D.
• Blaine Goodman
• Dennis Stephen Goodman, DO
• Karene Marie Goodman, NURSE PRACTITIONER
• Pamela N. Gray, PA-C
• Vernon Gary Green, OD

• Family Medicine Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.