Individual provider Active NPI

Scott Barry Goldman, PH.D.

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1356569453
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3929 Issued in AZ
Practice address
1 National Championship Dr # N108
Kasser Medical Treatment Center, McKale Center, U of a
Tucson, AZ 85721-0001
Phone
(520) 621-4674
Fax
(520) 621-8771
NPI assigned
Apr 23, 2007
Last updated
Jun 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 3929 AZ
Clinical Psychologist 103TC0700X 3929 AZ Primary
Exercise & Sports Psychologist 103TE1100X 3929 AZ

Addresses

Primary practice location

1 National Championship Dr # N108
Kasser Medical Treatment Center, McKale Center, U of a
Tucson, AZ 85721-0001

Mailing address

7775 E Castle Valley Way
Tucson, AZ 85750-7040
Phone (520) 820-1992

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 Philosophy

State licenses

LicenseStateTypeSpecialty
3929AZMDExercise & Sports Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1356569453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7775 E CASTLE VALLEY WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857507040",
            "telephone_number": "520-820-1992",
            "fax_number": "520-621-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NATIONAL CHAMPIONSHIP DR # N108",
            "address_2": "KASSER MEDICAL TREATMENT CENTER, MCKALE CENTER, U OF A",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857210001",
            "telephone_number": "520-621-4674",
            "fax_number": "520-621-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "SCOTT",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AZ",
            "license": "3929",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3929",
            "primary": true
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "AZ",
            "license": "3929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.