Robert J Goodrich, MD CST

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

License

16984 Issued in AZ

Practice address

1930 Mesquite Ave Ste 2
Lake Havasu City, AZ 86403-5772

Phone

(928) 854-7962

Fax

(928) 854-7963

NPI assigned

May 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1982838264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MESQUITE AVE STE 2",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035772",
            "telephone_number": "928-854-7962",
            "fax_number": "928-854-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MESQUITE AVE STE 2",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035772",
            "telephone_number": "928-854-7962",
            "fax_number": "928-854-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD CST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "AZ",
            "license": "16984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Goldstein, LCSW
• Alice Marie Gonzales, RN
• Jacob Benjamin Gonzalez, L.M.T.
• Lara Goodell, P.T.A.
• Kathryn Goodrich, SLP
• Goodwill of Northern Arizona
• Aditya R Goud, M.D.
• Martin John Goulooze, D.C.
• GR LHC, LLC
• Christian L Grandell, PA-C

• Obesity Medicine (Family Medicine) Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Obesity Medicine (Family Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.