Individual provider Active NPI

Marissa Goad, PHARMD

  • Pharmacist
  • Usaf Academy, CO
National Provider Identifier
1205486792
Registry record updated May 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA.0023485 Issued in CO
Practice address
4102 Pinion Dr
Usaf Academy, CO 80840-2502
Phone
(719) 333-2025
NPI assigned
Sep 16, 2019
Last updated
May 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S024277 AZ
Pharmacist 183500000X PHA.0023485 CO Primary

Addresses

Primary practice location

4102 Pinion Dr
Usaf Academy, CO 80840-2502

Mailing address

600 Marshall Rd
Superior, CO 80027-9730
Phone (720) 587-1000

Other practice location 1

600 Marshall Rd
Superior, CO 80027-9730
Phone (720) 587-1000

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Phoenix
Other URL EPRN

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S024277AZMDPharmacist
PHA.0023485COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
German Dobson CVS LLC PastSince Sep 1, 2019 Accepting new patients
German Dobson CVS LLC PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651363200000",
    "number": "1205486792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MARSHALL RD",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800279730",
            "telephone_number": "720-587-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Marshall Rd",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "CO",
            "postal_code": "800279730",
            "country_code": "US",
            "telephone_number": "720-587-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOAD",
        "first_name": "MARISSA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S024277",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0023485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Phoenix",
            "affiliation": "N",
            "address_1": "3933 E Camelback Rd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850182609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPRN",
            "affiliation": "N",
            "address_1": "17761 Cottonwood Dr",
            "city": "Parker",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801343925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

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