Active NPI
Steven Lee Goedert, O.D.
- Optometrist
- Redding, CA
National Provider Identifier
1780771584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5674T
- Practice address
- 1465 Victor Ave
Ste. D
Redding, CA 96003 - Phone
- (530) 722-0200
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5674T | CA | Primary |
Addresses
Primary practice location
1465 Victor Ave
Ste. D
Redding, CA 96003
Mailing address
1465 Victor Ave
Ste. D
Redding, CA 96003
Phone (530) 722-0200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 26, 2016 through May 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5674T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398211200000",
"number": "1780771584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 VICTOR AVE",
"address_2": "STE. D",
"city": "REDDING",
"state": "CA",
"postal_code": "96003",
"telephone_number": "530-722-0200",
"fax_number": "530-722-0210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 VICTOR AVE",
"address_2": "STE. D",
"city": "REDDING",
"state": "CA",
"postal_code": "96003",
"telephone_number": "530-722-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEDERT",
"first_name": "STEVEN",
"middle_name": "LEE",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2014-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5674T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.