Eli Nathan Goodman, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0101255858 Issued in VA

Practice address

6600 Northside High School Rd
Roanoke, VA 24019-2825

Phone

(540) 561-6615

NPI assigned

Dec 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1619212149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 NORTHSIDE HIGH SCHOOL RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240192825",
            "telephone_number": "540-561-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 NORTHSIDE HIGH SCHOOL RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240192825",
            "telephone_number": "540-561-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ELI",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-10",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A117798",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101255858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ora Goodbar, CRNA
• Stephanie Ann Goodbar, LCSW
• Diane Sue Goode, RNC, NNP
• Jeffrey Edwin Goode, M.D.
• Abigail Angel Goodman, PA
• Michelle Page Goodman, PMHNP-BC
• Dasha'Nae Nekole Goodrich
• Mackenzie Goodrich, DO
• Goodwill Industries of the Valleys - Roanoke
• Corey Goodwin, PHARMD

• Anatomic Pathology & Clinical Pathology Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.