Active NPI
Ronald A. Goebel, PH.D.
- Clinical Neuropsychologist
- Shreveport, LA
National Provider Identifier
1386612042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 217
- Practice address
- 3341 Youree Dr Ste 20a
Shreveport, LA 71105-2149 - Phone
- (318) 425-2000
- NPI assigned
- Mar 9, 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 217 | LA | Primary |
Addresses
Primary practice location
3341 Youree Dr Ste 20a
Shreveport, LA 71105-2149
Mailing address
3341 Youree Dr Ste 20a
Shreveport, LA 71105-2149
Phone (318) 425-2000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20502 | Other | LA | BLUE CROSS/BLUE SHIELD |
| 009760 | Other | LA | VALUE OPTIONS |
| 83958 UBS | Other | LA | UNITED BEHAVIORAL HEALTH |
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 Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1386612042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3341 YOUREE DR STE 20A",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052149",
"telephone_number": "318-425-2000",
"fax_number": "318-424-2601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3341 YOUREE DR STE 20A",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052149",
"telephone_number": "318-425-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEBEL",
"first_name": "RONALD",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "LA",
"license": "217",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "20502",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "009760",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "83958 UBS",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.