Jack A. Goble Jr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0001029 Issued in MD

Practice address

10755 Falls Rd
Suite 160
Lutherville, MD 21093-4515

Phone

(410) 285-2777

NPI assigned

Feb 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Medlantic Healthcare Group

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1467408450
  NPD (past)
• Hanover Health Corporation

  dba Hanover Medical Group

  • Multi-Specialty Clinic/Center
  • Hanover, PA
  • NPI 1093944779
  NPD (past)

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1366715625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LEE ST",
            "city": "STEWARTSTOWN",
            "state": "PA",
            "postal_code": "173634061",
            "telephone_number": "717-578-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 FALLS RD",
            "address_2": "SUITE 160",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934515",
            "telephone_number": "410-285-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBLE",
        "first_name": "JACK",
        "middle_name": "A.",
        "name_prefix": "Prof.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0001029",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002128L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosanna B Gibbons, R D
• Emily Groschan Gibson, PT, DPT
• Rebecca Ellen Gibson, LCSW-C
• Glen Elyn Anesthesia Associates, LLC
• Glimmer Counseling, LLC
• Adva Nofar Goldberg, LMT
• Mark Goldberg
• Kristy Ann Golden, D.P.M
• Jason Neil Goldstein, M.D., F.A.A.P.
• Diane M Golub, O.D.

• Medical Physician Assistant in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.