Stephen J Goodman, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

0101023891 Issued in VA

Practice address

2722 Merrilee Dr
Suite 230
Fairfax, VA 22031-4400

Phone

(703) 698-4483

Fax

(703) 573-0880

NPI assigned

Jul 17, 2006

Reactivated

Apr 15, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1962420968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 WOODBINE ST",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154957",
            "telephone_number": "301-657-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "SUITE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314400",
            "telephone_number": "703-698-4483",
            "fax_number": "703-573-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-04-22",
        "deactivation_date": "2012-06-04",
        "reactivation_date": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "VA",
            "license": "0101023891",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "VA",
            "license": "0101023891",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "VA",
            "license": "0101023891",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "VA",
            "license": "0101023891",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101023891",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "VA",
            "license": "0101023891",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "VA",
            "license": "0101023891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Agape Divine Gooden, RDN
• Elizabeth Shelly Goodiel, C.R.N.F.A,M.S.N.,CNM
• Kristen Nicole Goodman
• Kristin Bentivogli Goodman, DPT
• Sarah Nicole Goodman, NONE
• Goodwill Homes LLC
• Goodwill Homes LLC
• Brian Goodwin, PT, DPT
• Lyndon K Goodwin, MD
• Keerti Goorah, DPT

• Diagnostic Radiology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Diagnostic Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.