Active NPI
David Markus Goodrich, CRNA
- Certified Registered Nurse Anesthetist
- Pueblo, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- APN12279
- Practice address
- 1218 N Main St
Pueblo, CO 81003-2828 - Phone
- (719) 543-7877
- Fax
- (719) 543-7882
- NPI assigned
- Oct 24, 2006
- Last updated
- Jun 9, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | APN12279 | TN | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | RN99907 | TN |
Addresses
Primary practice location
1218 N Main St
Pueblo, CO 81003-2828
Mailing address
1218 N Main St
Pueblo, CO 81003-2828
Phone (719) 543-7877
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3636921 | Medicaid | TN | |
| 4137595 | Other | TN | BCBS OF TN |
| P00371821 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921
4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN12279 | TN | MD | Certified Registered Nurse Anesthetist |
| RN99907 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Pueblo Pathology Group, PC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Anesthesiologists Associated PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesiologists Associated PC | Past | Accepting new patients | |
| Matthew J Furman, D.O. LLC | Past | Accepting new patients |
Locations
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760
400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000
Organizations & group practices 6
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.
-
dba UCHealth Medical Group
- General Practice Physician
- Loveland, CO
- NPI 1225356868
-
dba UCHealth Medical Group
- General Practice Physician
- Loveland, CO
- NPI 1366763260
-
- Anatomic Pathology & Clinical Pathology Physician
- Pueblo, CO
- NPI 1275690588
-
- Pain Medicine Physician
- Pueblo, CO
- NPI 1952739427
-
- Certified Registered Nurse Anesthetist
- Chattanooga, TN
- NPI 1043278443
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Chattanooga, TN
- NPI 1518923705
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1184263527
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1376183145
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1417596834
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1427689652
-
dba Parkview Medical Center
- General Acute Care Hospital
- Pueblo, CO
- NPI 1104881507
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1134751712
-
dba Parkview Pueblo West
- General Acute Care Hospital
- Pueblo West, CO
- NPI 1821720681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1902989544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 N MAIN ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032828",
"telephone_number": "719-543-7877",
"fax_number": "719-543-7882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1218 N MAIN ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032828",
"telephone_number": "719-543-7877",
"fax_number": "719-543-7882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "DAVID",
"middle_name": "MARKUS",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "APN12279",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "RN99907",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3636921",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TN",
"identifier": "4137595",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00371821",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.