Active NPI
Edwin Marlowe Goble, MD
- Orthopaedic Surgery Physician
- Logan, UT
National Provider Identifier
1235232646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 1215111205
- Practice address
- 274 N Main St
Logan, UT 84321-3915 - Phone
- (435) 753-1600
- Fax
- (435) 753-9521
- NPI assigned
- Sep 7, 2006
- Last updated
- Apr 16, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 1215111205 | CT | Primary |
Addresses
Primary practice location
274 N Main St
Logan, UT 84321-3915
Mailing address
2380 N 400 E
Suite G
N Logan, UT 84341
Phone (435) 752-4665
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1215111205 | CT | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Lincoln County Hospital District | Past | Accepting new patients | |
| Medical Imaging Associates of Idaho Falls, Inc | Past | 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.
-
- Diagnostic Radiology Physician
- Pocatello, ID
- NPI 1740225531
-
dba Star Valley Medical Center
- Critical Access Hospital
- Afton, WY
- NPI 1255376406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334534400000",
"number": "1235232646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2380 N 400 E",
"address_2": "SUITE G",
"city": "N LOGAN",
"state": "UT",
"postal_code": "84341",
"telephone_number": "435-752-4665",
"fax_number": "435-752-4662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "274 N MAIN ST",
"city": "LOGAN",
"state": "UT",
"postal_code": "843213915",
"telephone_number": "435-753-1600",
"fax_number": "435-753-9521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOBLE",
"first_name": "EDWIN",
"middle_name": "MARLOWE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2012-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CT",
"license": "1215111205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.