Douglas Goforth, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Fruita, CO
NPI 1942534334 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1942534334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- POD.0000712 (CO)
- Practice address
- 401 Kokopelli Blvd Ste 1
Fruita, CO 81521-3308 - Phone
- (970) 858-2530
- Fax
- (970) 858-1196
- NPI assigned
- Oct 1, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
P O Box
Suite 130
Fruita, CO 81521-0130
PO Box
Suite 130
Fruita, CO 81521
Hospital & facility affiliations
- Family Health West Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120924000454 | CO | Practitioner - Podiatry | 9931357563 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POD.0000712 | CO | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lower Valley Hospital Association | Current | Accepting new patients | |
| Lower Valley Hospital Association | Current |
Accepting new patients | |
| Lower Valley Hospital Association | Current |
Accepting new patients | |
| Lower Valley Hospital Association | Current |
Accepting new patients |
Locations
401 Kokopelli Blvd
Ste 1
Fruita, CO 81521
Phone (970) 858-2705
300 W Ottley Ave
#W
Fruita, CO 81521
281 N Plum St
Fruita, CO 81521
Phone (970) 858-2530
300 W Ottley Ave
Fruita, CO 81521
Phone (970) 858-3900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | POD.0000712 | CO | Yes |
Addresses
Primary practice location
401 Kokopelli Blvd Ste 1
Fruita, CO 81521-3308
Mailing address
PO Box 130
Fruita, CO 81521-0130
Phone (970) 858-2186
Other practice location 1
300 W Ottley Ave
Fruita, CO 81521-2118
Phone (970) 858-2186
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | douglasgoforth@fhwco.cernerdirect.com | Direct |
Other providers in Fruita, CO
- Gary Andreoletti DDS PC
- Joshua Gavin
- Susan Jean Gemmell-Crosby
- Janice K Gifford
- Dawn Marie Glenn
- Grand Valley Dental Sleep Associates,LLC
- Brittany Noelle Grant
- Troy Alexander Griffiths
- Guardian Transport & Security LLC
- Guardian Transport and Security
All providers in Fruita, CO · Foot & Ankle Surgery Podiatrist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.