Active NPI
Robert A Goodloe, PHARM D
- Pharmacist
- Rock Island, IL
National Provider Identifier
1306127428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 054.008634
- Practice address
- 3100 11TH St
Rock Island, IL 61201-6706 - Phone
- (309) 786-4312
- Fax
- (309) 786-1619
- NPI assigned
- Sep 1, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 054.008634 | IL | Primary |
| Pharmacist | 183500000X | 16033 | IA | |
| Pharmacist | 183500000X | 4344 | NM |
Addresses
Primary practice location
3100 11TH St
Rock Island, IL 61201-6706
Mailing address
3100 11TH St
Rock Island, IL 61201-6706
Phone (309) 786-4312
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16033 | IA | MD | Pharmacist |
| 054.008634 | IL | MD | Pharmacist |
| 4344 | NM | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
-
- Pharmacy
- Rock Island, IL
- NPI 1164437380
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314835200000",
"number": "1306127428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 11TH ST",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612016706",
"telephone_number": "309-786-4312",
"fax_number": "309-786-1619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 11TH ST",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612016706",
"telephone_number": "309-786-4312",
"fax_number": "309-786-1619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODLOE",
"first_name": "ROBERT",
"middle_name": "A",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-01",
"last_updated": "2011-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "054.008634",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "16033",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "4344",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.