Individual provider Active NPI

Lisa Kay Goodin, RPH

  • Pharmacist
  • Surprise, AZ
National Provider Identifier
1174853329
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S012819 Issued in AZ
Practice address
13770 W Bell Rd
Surprise, AZ 85374-3865
Phone
(623) 544-2226
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S012819 AZ Primary

Addresses

Primary practice location

13770 W Bell Rd
Surprise, AZ 85374-3865

Mailing address

13770 W Bell Rd
Surprise, AZ 85374-3865
Phone (623) 544-2226

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
S012819AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1174853329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743865",
            "telephone_number": "623-544-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13770 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743865",
            "telephone_number": "623-544-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "LISA",
        "middle_name": "KAY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S012819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.