Douglas Goderwis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

27947 Issued in KY

Practice address

7300 Turfway Rd
Florence, KY 41042-1375

Phone

(859) 212-4700

Fax

(859) 212-4761

NPI assigned

May 30, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

University of Louisville School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Home Care Home health agency, Florence, KY, CCN 187075
• Amedisys Home Health of Kentucky Home health agency, Crestview Hills, KY, CCN 187179
• Centerwell Home Health Home health agency, Fort Mitchell, KY, CCN 187058
• St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
• St Elizabeth Florence Hospital, Florence, KY, CCN 180045
• St Elizabeth Grant Hospital, Williamstown, KY, CCN 181311
• St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dgoderwis2975@direct-prd.stelizabeth.com

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.

• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Summit Medical Group, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys SP-Oh, L.L.C.

  • Home Health Agency
  • Crestview Hills, KY
  • NPI 1215940093
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Fort Mitchell, KY
  • NPI 1831122563
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • Critical Access Hospital
  • Williamstown, KY
  • NPI 1114974813
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Florence, KY
  • NPI 1154365062
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Fort Thomas, KY
  • NPI 1740221795
  Care Compare affiliation
• St. Elizabeth Home Care Services, LLC

  • Home Health Agency
  • Florence, KY
  • NPI 1316136534
  Care Compare affiliation

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1760439095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-4700",
            "fax_number": "859-212-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 TURFWAY RD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421375",
            "telephone_number": "859-212-4700",
            "fax_number": "859-212-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODERWIS",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "27947",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "27947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0723542",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64279474",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chase R Gima, DC
• Patrick J Ginney, DPM
• Diane Carol Glenn, APRN, FNP-C, SANE
• Gloxel Mental and Behavioral Health LLC
• Stephanie Godersky
• Kelsey Goderwis, PHARMD
• Joanna Goldie
• Philip Mark Goldman, M.D.
• Stephen Louis Goldstein, P.T.
• Gina Goldston, BS

• Internal Medicine Physician in Florence, KY
• Providers in Florence, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.