Raymond C. Goodman, O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100008 Issued in ID

Legal business name

RAYMOND C. GOODMAN, O.D., P.A.

Doing business as

Eyecare Center of Gooding PA

Practice address

317 Main St
Gooding, ID 83330-1302

Phone

(208) 934-4856

Fax

(208) 934-5818

NPI assigned

Mar 14, 2007

Last updated

Jan 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raymond Clyde Goodman, O.D.NPI 1407859739

Title

President

Phone

(208) 934-4856

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eyecare Center of Gooding PA Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raymond C. Goodman, O.D.

  • Optometrist
  • Gooding, ID
  • NPI 1407859739
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1619000940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 MAIN ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301302",
            "telephone_number": "208-934-4856",
            "fax_number": "208-934-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 MAIN ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301302",
            "telephone_number": "208-934-4856",
            "fax_number": "208-934-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND C. GOODMAN, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-934-4856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4776340001",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA2306",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Center of Gooding PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Gooding, ID
• Providers in Gooding, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.