NPIMap

Individual provider Active NPI

David H Good, D.O.

  • Family Medicine Physician
  • Wagoner, OK
National Provider Identifier
1780009969
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2864 Issued in OK
Practice address
1202 W. Cherokee St
Ste E
Wagoner, OK 74467
Phone
(918) 485-1877
Fax
(918) 485-0535
NPI assigned
Feb 25, 2014
Last updated
Jan 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2864 OK Primary

Addresses

Primary practice location

1202 W. Cherokee St
Ste E
Wagoner, OK 74467

Mailing address

1200 W. Cherokee St.
Wagoner, OK 74467
Phone (918) 485-5514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141015001615 OK Practitioner - Family Practice 4688895766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wagoner Hospital AuthorityGroup PAC ID 0042217531, 20 clinicians

Practice addresses (Care Compare)

1200 W Cherokee St
Wagoner, OK 74467-4624
Phone (918) 485-5514

1202 W Cherokee St
Wagoner, OK 74467-4629

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as individual
Quality
49.55
Promoting interoperability
100
Improvement activities
40
Cost
81.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2864OKMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: david.good.1@14254.direct.athenahealth.com
  • Direct secure messaging: david.good.1@17061.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wagoner Community HospitalWagoner, OK, CCN 370166 Hospital Corporate Officer
Other		 May 15, 2019
May 15, 2019
Wagoner Community HospitalWagoner, OK, CCN 37U166 Hospital Corporate Officer
Other		 May 15, 2019
May 15, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1780009969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W. CHEROKEE ST.",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "74467",
            "telephone_number": "918-485-5514",
            "fax_number": "918-485-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W. CHEROKEE ST",
            "address_2": "STE E",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "74467",
            "telephone_number": "918-485-1877",
            "fax_number": "918-485-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "DAVID",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

Verify at the official NPI Registry.