Mark David Goodman, PHD FPPR

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

374 Issued in KS

Practice address

125 W. 2ND Avenue
Suite E
Hutchinson, KS 67501-5300

Phone

(620) 663-4802

Fax

(620) 663-9867

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark D. Goodman

  • Clinical Psychologist
  • Hutchinson, KS
  • NPI 1447565866
  NPD (past) Authorized official
• Hutchinson Psychological Services

  • Clinical Psychologist
  • Hutchinson, KS
  • NPI 1972043040
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1629039854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1221",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675041221",
            "telephone_number": "620-663-4802",
            "fax_number": "620-663-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W. 2ND AVENUE",
            "address_2": "SUITE E",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675015300",
            "telephone_number": "620-663-4802",
            "fax_number": "620-663-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHD  FPPR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237680A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Years Senior Care Home
• Audra Lyn Goldsmith, LMLP
• Barbara Gombosi, T-LMLP
• Christina Marie Gomez-Martin, BSN RN, FNE
• Samantha Goodall, LPC
• Terry Lynne Goss, PT
• Roberta Graber, LSCSW
• Grace Home Health Care, Inc,
• Darla R Graham, ARNP
• Grant D. Ringler, D.D.S., PA

• Clinical Psychologist in Hutchinson, KS
• Providers in Hutchinson, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.