Goodside Health Medical, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

GOODSIDE HEALTH MEDICAL, PLLC

Practice address

8601 N Black Canyon Hwy Ste 103-3
Phoenix, AZ 85021-4109

Phone

(281) 203-5006

NPI assigned

Jun 7, 2022

Organization subpart

No

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

Authorized official

Name

Gerardo Reyes, MDNPI 1194767954

Title

Owner

Phone

(281) 203-5006

Specialties & licenses 7

Addresses

Tax ID family

Goodside Health Medical PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Metairie, LA
  • NPI 1235869165
  NPD tax ID
• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Pittsburgh, PA
  • NPI 1467181305
  NPD tax ID
• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Rocky River, OH
  • NPI 1699404541
  NPD tax ID
• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Cedar Rapids, IA
  • NPI 1790415909
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerardo Reyes, M.D., M.B.A.

  • Pediatric Critical Care Medicine Physician
  • Savannah, GA
  • NPI 1194767954
  NPD (past) Authorized official

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1104555044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 RIVER RUN STE 302",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076547",
            "telephone_number": "281-203-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 N BLACK CANYON HWY STE 103-3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214109",
            "telephone_number": "281-203-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODSIDE HEALTH MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-203-5006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Goodrich III, LPC
• Michelle Goodrich, PTA
• Tanesia N Goodrich
• Gabrielle Goodrick, MD
• Bradley Porter Goodsell, D.O.
• Laurel Goodson
• Naomi Lynnette Goodson, LMT
• Shawn Goodson
• Goodsteps Behavioral Home LLC
• Goodwill Industries of Central Arizona

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.