Individual provider Active NPI

Robert Emory Goodman, M.D.

  • Rheumatology Physician
  • Shreveport, LA
National Provider Identifier
1235111907
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
15562 Issued in LA
Practice address
740 Jordan St
Shreveport, LA 71101-4616
Phone
(318) 424-9240
Fax
(318) 424-0022
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 15562 LA Primary

Addresses

Primary practice location

740 Jordan St
Shreveport, LA 71101-4616

Mailing address

740 Jordan St
Shreveport, LA 71101-4616
Phone (318) 424-9240

Other identifiers 2

IdentifierTypeStateIssuer
110043608OtherLARAILROAD MEDICARE
1348465MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
23.6 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15562LAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Bird Perkins Cancer Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: arthritisandrheumatologyclinic@arthritisandrheumatologyclinic.ssdirect.aprima.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1235111907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014616",
            "telephone_number": "318-424-9240",
            "fax_number": "318-424-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014616",
            "telephone_number": "318-424-9240",
            "fax_number": "318-424-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ROBERT",
        "middle_name": "EMORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "15562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110043608",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1348465",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.