Blaine Goodman

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2019012508 Issued in MO

Practice address

1000 W 10TH St
Rolla, MO 65401-2905

Phone

(573) 458-8899

NPI assigned

May 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Anesthesia Care PCGroup PAC ID 5799698551, 43 clinicians

Western Anesthesiology Associates IncGroup PAC ID 6204720667, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Comprehensive Anesthesia Care PC

  • Anesthesiology Physician
  • Chesterfield, MO
  • NPI 1215975156

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Western Anesthesiology Associates, Inc.

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1275646754
  Medicare reassignment Care Compare group NPD

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

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1104483718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 OAK KNOLL RD",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "BLAINE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019012508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Eleanor Givens, PHD
• Glenn a Kunkel MD LLC
• God Loves You Counseling LLC
• Gilda Haydee Gomez, M.D.
• Goodman Medical Center PC
• Dennis Stephen Goodman, DO
• Karene Marie Goodman, NURSE PRACTITIONER
• Pamela N. Gray, PA-C
• Vernon Gary Green, OD
• W Elaine Grover, MS

• Certified Registered Nurse Anesthetist in Rolla, MO
• Providers in Rolla, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.