Active NPI
David R Goodspeed, C. PED.
- Orthotic Fitter
- Rutland, VT
National Provider Identifier
1689828253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- 20215273
- Practice address
- 106 Allen St
Rutland, VT 05701-4542 - Phone
- (802) 773-1543
- NPI assigned
- Nov 10, 2008
- 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 |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | 20215273 | VT | Primary |
Addresses
Primary practice location
106 Allen St
Rutland, VT 05701-4542
Mailing address
106 Allen St
Rutland, VT 05701-4542
Phone (802) 773-1543
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1006112 | Medicaid | VT | |
| 1016140001 | Other | VT | NGS SUPPLIER |
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 |
|---|---|---|---|
| 20215273 | VT | MD | Orthotic Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bilancia Inc | Current | Accepting new patients |
Locations
106 Allen St
Rutland, VT 05701
Phone (802) 773-1543
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1689828253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 ALLEN ST",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014542",
"telephone_number": "802-773-1543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 ALLEN ST",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014542",
"telephone_number": "802-773-1543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSPEED",
"first_name": "DAVID",
"middle_name": "R",
"credential": "C. PED.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-10",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "VT",
"license": "20215273",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1006112",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NGS SUPPLIER",
"identifier": "1016140001",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.