Individual provider Active NPI

Mathurin Quin Goodheart

  • Behavior Technician
  • Meridian, ID
National Provider Identifier
1780472811
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1905 S Topaz Way Unit 100
Meridian, ID 83642-4477
Phone
(208) 417-7971
NPI assigned
Apr 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1905 S Topaz Way Unit 100
Meridian, ID 83642-4477

Mailing address

2885 N Records Ave Apt P102
Meridian, ID 83646-6708
Phone (208) 570-2207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1780472811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 N RECORDS AVE APT P102",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466708",
            "telephone_number": "208-570-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S TOPAZ WAY UNIT 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424477",
            "telephone_number": "208-417-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODHEART",
        "first_name": "MATHURIN",
        "middle_name": "QUIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.