Eric A Goulder, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35041792 Issued in OH

Practice address

400 Matthew St
Ste 302
Marietta, OH 45750-1644

Phone

(740) 568-5207

Fax

(740) 568-5297

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2018 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1598760969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8989 FILIZ LN",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MATTHEW ST",
            "address_2": "STE 302",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501644",
            "telephone_number": "740-568-5207",
            "fax_number": "740-568-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDER",
        "first_name": "ERIC",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35041792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005592000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "P00457495",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000650665",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0498288",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - MMH",
            "identifier": "P01721803",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000696918",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shayla Goldenberg, PHARM.D.
• Dakota Goldsberry
• Michael Alan Goldsberry II, PT, DPT
• Ayla Gordon, M.D.
• Jonathan Jacobey Gore
• Amandeep Goyal, MD
• Amanda Graff
• Caitlyn Alexandria Gragg, DNP, ACNP
• Sally Jane Greathouse
• William F Green, CRNA

• Cardiovascular Disease Physician in Marietta, OH
• Providers in Marietta, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.