Goodwill Industries of NE Iowa Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GOODWILL INDUSTRIES OF NE IOWA INC

Practice address

2640 Falls Ave
Waterloo, IA 50701-5722

Phone

(319) 234-4626

Fax

(319) 234-2504

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

David E Boyd

Title

President Ceo

Phone

(319) 234-4626

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1760548440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 FALLS AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015722",
            "telephone_number": "319-234-4626",
            "fax_number": "319-234-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 FALLS AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015722",
            "telephone_number": "319-234-4626",
            "fax_number": "319-234-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF NE IOWA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "319-234-4626"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0234286",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0741801",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas J Goetsch, D.O.
• Brian Goldfine, MT-BC
• Nicole Elizabeth Gonzalez, MD
• Emily Goodenbour
• David Wayne Goodson, MSW
• Laura L Gorman, PHD
• Mark Gorsche, M.D.
• Thomas Stewart Gorsche, MD
• Carrayn Niccole Gossman, NP
• Matthew J Grady, M.D.

• Community Based Hospice Care Agency in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Community Based Hospice Care Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.