Gretchen Shay Goodman, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601000770 Issued in MI

Practice address

350 Lafayette Ave SE
Grand Rapids, MI 49503-4656

Phone

(616) 456-8515

Fax

(616) 456-8208

NPI assigned

Jan 18, 2015

Last updated

Jan 18, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mary Free Bed Rehabilitation Hospital

  • Rehabilitation Hospital
  • Grand Rapids, MI
  • NPI 1730133463
  NPD (past)

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

{
    "created_epoch": "1421539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421539200000",
    "number": "1356730048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5646 VIA NUEVO DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419404",
            "telephone_number": "616-334-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LAFAYETTE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034656",
            "telephone_number": "616-456-8515",
            "fax_number": "616-456-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "GRETCHEN",
        "middle_name": "SHAY",
        "name_prefix": "Mrs.",
        "credential": "AT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-18",
        "last_updated": "2015-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601000770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Good, PA
• Krista Joy Good, CRNA
• Sarah Good
• Lee R Goodfellow, O.D.
• Amanda Marie Goodin, OTR/L
• Michele Goodman, PT
• Michelle S Goodman, LLBSW
• Seth Goodman
• Alexandria Goodnough, OTR/L
• Goodrich Counseling

• Athletic Trainer in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2015; 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.