Active NPI
Mathew Goodrich
- Basic Emergency Medical Technician
- Missoula, MT
National Provider Identifier
1508377490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- 26233
- Practice address
- 2827 Fort Missoula Rd
Missoula, MT 59804-7408 - Phone
- (406) 327-4171
- NPI assigned
- Oct 18, 2017
- 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 |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 26233 | MT | Primary |
Addresses
Primary practice location
2827 Fort Missoula Rd
Missoula, MT 59804-7408
Mailing address
950 Mount Ave Apt 202
Missoula, MT 59801-5662
Phone (406) 702-9386
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26233 | MT | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508284800000",
"number": "1508377490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 MOUNT AVE APT 202",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598015662",
"telephone_number": "406-702-9386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2827 FORT MISSOULA RD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598047408",
"telephone_number": "406-327-4171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "MATHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-18",
"last_updated": "2017-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "MT",
"license": "26233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.