NPIMap

Organization Active NPI

Brent H. Goodsell, DO

  • Dermatology Physician
  • American Fork, UT
National Provider Identifier
1861861155
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
343150-1204 Issued in UT
Legal business name
BRENT H. GOODSELL, DO
Practice address
162 S 1100 E
American Fork, UT 84003-2817
Phone
(801) 756-9669
NPI assigned
Sep 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Authorized official

Name
Mrs. Denise T. Stewart
Title
Billing Manager
Phone
(801) 756-9669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 343150-1204 UT Primary

Addresses

Primary practice location

162 S 1100 E
American Fork, UT 84003-2817

Mailing address

162 South 1100 East
American Fork, UT 84003
Phone (801) 756-9669

National Provider Directory

National Provider Directory

Locations

162 S 1100 E
American Fork, UT 84003
Phone (801) 756-9669

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1861861155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 SOUTH 1100 EAST",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "84003",
            "telephone_number": "801-756-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 S 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032817",
            "telephone_number": "801-756-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT H. GOODSELL, DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "801-756-9669",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "UT",
            "license": "343150-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.