Kevin Goodluck, MD

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

97-251 Issued in NM

Practice address

4600 Montgomery Blvd NE
BLDG B, Ste 100
Albuquerque, NM 87109

Phone

(505) 924-5840

Fax

(505) 924-5841

NPI assigned

Oct 3, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1710071196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91224",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871991224",
            "telephone_number": "505-924-5840",
            "fax_number": "505-924-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY BLVD NE",
            "address_2": "BLDG B, STE 100",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-924-5840",
            "fax_number": "505-924-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLUCK",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "NM",
            "license": "97-251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81783311",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Lynn Gooden
• Amanda Goodfox
• Goodhope Health Services NM
• Charles J Goodis, DDS
• Robert Wicksman Goodkind, PH.D.
• Thomas N Goodluck, LADA
• Jolie Goodman-Leibof
• Andrea Marie Goodman, MSPAS, PA-C
• Cheryl Lynn Goodman, PCC
• Elena Goodman

• Phlebology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Phlebology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.