Active NPI
Mark D. Goodman
- Clinical Psychologist
- Hutchinson, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 374
- Legal business name
- MARK D. GOODMAN
- Practice address
- 125 W 2ND Ave
Suite E
Hutchinson, KS 67501-5300 - Phone
- (620) 663-4802
- Fax
- (620) 663-9867
- NPI assigned
- Aug 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark D. Goodman, PHD, FPPR
- Title
- Licensed Psychologist
- Phone
- (620) 727-6569
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 374 | KS | Primary |
Addresses
Primary practice location
125 W 2ND Ave
Suite E
Hutchinson, KS 67501-5300
Mailing address
125 W 2ND Ave
Suite E
Hutchinson, KS 67501-5300
Phone (620) 663-4802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100237680A | Medicaid | KS |
National Provider Directory
National Provider Directory- Tax ID family
- Hutchinson Psychological Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Psychologist
- Hutchinson, KS
- NPI 1972043040
Locations
125 W 2nd Ave
Ste E
Hutchinson, KS 67501
Phone (620) 663-4802
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- Hutchinson, KS
- NPI 1629039854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1281398400000",
"number": "1447565866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 W 2ND AVE",
"address_2": "SUITE E",
"city": "HUTCHINSON",
"state": "KS",
"postal_code": "675015300",
"telephone_number": "620-663-4802",
"fax_number": "620-663-9867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W 2ND AVE",
"address_2": "SUITE E",
"city": "HUTCHINSON",
"state": "KS",
"postal_code": "675015300",
"telephone_number": "620-663-4802",
"fax_number": "620-663-9867"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARK D. GOODMAN",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A",
"authorized_official_last_name": "GOODMAN",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
"authorized_official_telephone_number": "620-727-6569",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD, FPPR"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "374",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100237680A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hutchinson, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.