Individual provider Active NPI

Daniel P Goodrich, MD

  • Family Medicine Physician
  • Concord, NC
National Provider Identifier
1457370199
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200401503 Issued in NC
Practice address
270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2441
Phone
(704) 786-6521
Fax
(704) 782-9703
NPI assigned
Jul 19, 2006
Last updated
Oct 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200401503 NC Primary

Addresses

Primary practice location

270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2441

Mailing address

270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2441
Phone (704) 786-6521

Other identifiers 1

IdentifierTypeStateIssuer
1457370199MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061019000250 NC Practitioner - Family Practice 4688670383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

1200 N Elm St
Greensboro, NC 27401-1020

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Family Medicine Current Accepting new patients
Moses Cone Physician Services Inc CurrentSince Oct 1, 2010 Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Oct 1, 2010 Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients
Cabarrus Family Medicine Past Accepting new patients
Cabarrus Family Medicine Past Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1200 N Elm St
#5
Greensboro, NC 27401
Phone (336) 832-5777

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1457370199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE",
            "address_2": "SUITE 102",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-786-6521",
            "fax_number": "704-782-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE",
            "address_2": "SUITE 102",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-786-6521",
            "fax_number": "704-782-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200401503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457370199",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.