Teresa Dudek Goodpaster, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME98349 Issued in FL

Practice address

3051 6TH Street
Marianna, FL 32446-1933

Phone

(850) 482-0017

NPI assigned

Sep 20, 2005

Last updated

Jan 22, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Teresa Ann Dudek Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• St. Petersburg General Surgery LLC

  • Surgery Physician
  • St Petersburg, FL
  • NPI 1033243274
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1801882428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 6TH STREET",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461933",
            "telephone_number": "850-482-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 6TH STREET",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461933",
            "telephone_number": "850-482-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODPASTER",
        "first_name": "TERESA",
        "middle_name": "DUDEK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35-06-3092-D",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME98349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279095500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "DUDEK",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kinsey Gilmore, MS, LD/N, IBCLC
• Daericca Janae Godwin
• Pamela Godwin
• Richard C Goff, M.D.
• Amber L Goodman, PT
• Tonya Goodson, ARNP-BC
• Erin L Goodwin, MS, RD, LD,/N, IBCLC
• Imani Carolyn Goodwin, PHD, RN, FNP-BC
• Kayla L Gore, CRNA
• Tiffany Amber Granger

• Surgery Physician in Marianna, FL
• Providers in Marianna, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.