Goodside Health Medical, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

GOODSIDE HEALTH MEDICAL, PLLC

Practice address

3300 Southgate CT SW
Ste 183
Cedar Rapids, IA 52404

Phone

(281) 203-5006

NPI assigned

Jun 13, 2022

Last updated

Jul 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerardo Reyes, MDNPI 1194767954

Title

Owner

Phone

(281) 203-5006

Specialties & licenses 7

Addresses

Tax ID family

Goodside Health Medical PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1104555044
  NPD tax ID
• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Metairie, LA
  • NPI 1235869165
  NPD tax ID
• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Pittsburgh, PA
  • NPI 1467181305
  NPD tax ID
• Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Rocky River, OH
  • NPI 1699404541
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerardo Reyes, M.D., M.B.A.

  • Pediatric Critical Care Medicine Physician
  • Savannah, GA
  • NPI 1194767954
  NPD (past) Authorized official

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1790415909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 RIVER RUN STE 302",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076547",
            "telephone_number": "281-203-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 SOUTHGATE CT SW",
            "address_2": "STE 183",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52404",
            "telephone_number": "281-203-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODSIDE HEALTH MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-203-5006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Robert Goeller, DC
• Kendal Goering, DPT
• Vijaya Kumar Gogineni, MD
• Jenna Lee Goldsmith
• Lauren Goodlove, LMSW
• Kara Gootee, LMSW
• Donal Kevin Gordon, MD
• Lindsey Gordon
• Melissa Gordon, LMSW
• Sara Nan Gordon, ARNP

• Pediatrics Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.