Active NPI
Marjorie Millard Goodyear, P.A.
- Medical Physician Assistant
- Denver, CO
National Provider Identifier
1245408814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2084
- Practice address
- 3600 E Alameda Ave Ste 100
Denver, CO 80209-3135 - Phone
- (720) 266-6789
- NPI assigned
- Feb 15, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2084 | CO | Primary |
Addresses
Primary practice location
3600 E Alameda Ave Ste 100
Denver, CO 80209-3135
Mailing address
408 S Humboldt St
Denver, CO 80209-2533
Phone (303) 995-1736
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2084 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1245408814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 S HUMBOLDT ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802092533",
"telephone_number": "303-995-1736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 E ALAMEDA AVE STE 100",
"city": "DENVER",
"state": "CO",
"postal_code": "802093135",
"telephone_number": "720-266-6789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODYEAR",
"first_name": "MARJORIE",
"middle_name": "MILLARD",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-15",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "2084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.