Promenade Primary Care LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

PROMENADE PRIMARY CARE LLC

Doing business as

Kelly Goodman NP and Associates PC

Practice address

4701 Sangamore Rd
Suite S207
Bethesda, MD 20816-2508

Phone

(202) 684-7167

NPI assigned

Aug 18, 2016

Organization subpart

No

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

Authorized official

Name

Kelly Goodman, NP

Title

Owner

Phone

(202) 684-7167

Specialties & licenses 1

Addresses

Other names 1

• Kelly Goodman NP and Associates PC Doing business as

Locations

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1770038887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 LENFANT PLZ SW",
            "address_2": "SUITE 325",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200242119",
            "telephone_number": "202-684-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SANGAMORE RD",
            "address_2": "SUITE S207",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162508",
            "telephone_number": "202-684-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMENADE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-684-7167",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelly Goodman NP and Associates PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey Proctor, MS, RD, LDN
• Luiza Prodan, OD
• Scott Proestel, MD
• Professional Anesthesia Consultants, PC
• Progressive Physical Therapy, LLC
• Brandon W Propper, MD
• Jarred Propps
• Cristah Prost, MD
• Jacqueline Proto, OTR/L
• Bridgette Cian Provost, MD

• Primary Care Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.