Active NPI
Gary Goodenow, MD
- Obstetrics & Gynecology Physician
- Daytona Beach, FL
National Provider Identifier
1346309416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME44693
- Practice address
- 303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709 - Phone
- (386) 254-4121
- Fax
- (386) 258-4802
- NPI assigned
- Dec 6, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME44693 | FL | Primary |
Addresses
Primary practice location
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Mailing address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 254-4121
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 252074500 | Medicaid | FL | |
| ME44693 | Other | FL | STATE MEDICAL LICENSE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifax Healthcare Systems Inc | Obstetrics & Gynecology | Past | Accepting new patients |
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.
-
dba HHCSI Halifax Family Health Center
- Family Medicine Physician
- Daytona Beach, FL
- NPI 1245283530
Obstetrics & Gynecology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270425600000",
"number": "1346309416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142709",
"telephone_number": "386-254-4121",
"fax_number": "386-258-4802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142709",
"telephone_number": "386-254-4121",
"fax_number": "386-258-4802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODENOW",
"first_name": "GARY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2010-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME44693",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "252074500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "ME44693",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.