DR. ETHELYNN A GOODIN (NPI# 1093898025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093898025 |
| Entity Type | Individual |
| Full Name | DR. ETHELYNN A GOODIN |
| Credential | M.D. |
| Practice Address |
5920 Coliseum Blvd Alexandria LA 71303 |
| Practice Telephone | 3184439339 |
| Practice Fax Number | 3184439116 |
| Mailing Telephone | 3184439339 |
| Mailing Fax Number | 3184439116 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 04417R | LA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1199796 | 05 |
| Street Address |
5920 COLISEUM BLVD |
| City | ALEXANDRIA |
| State | LA |
| Zip Code | 71303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558309237 | Regina M Dekeyzer | Counselor | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2006-06-03 |
| 1497370969 | Patricia Kelly Moran Inc | Community/Behavioral Health | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2020-06-10 |
| 1902439219 | Shelley Gildwarg, Lcsw LLC | Social Worker | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2020-02-14 |
| 1376175471 | Edwin Urbi A Medical Limited Liabilty Company | Psychiatry & Neurology | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2020-02-06 |
| 1396394797 | Christina Brister, LLC | Nurse Practitioner | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2019-09-09 |
| 1952950255 | Elite Mental Health Services | Nurse Practitioner | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2019-09-09 |
| 1083261887 | A Healthy Mind Mental Health Services | Nurse Practitioner | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2019-08-26 |
| 1962059238 | Wakanda Mason | Nurse Practitioner | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2019-08-21 |
| 1730687872 | Lauri G. Haller, LLC | Nurse Practitioner | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2018-01-23 |
| 1811404957 | Lauri Guillory Haller | Nurse Practitioner | 5920 Coliseum Blvd, Alexandria, LA 71303-3714 | 2018-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346877370 | Victoria Bowie | Peer Specialist | 1405 Peterman Drive Suite A, Alexandria, LA 71303 | 2020-03-27 |
| 1396375051 | Christin Authement | Social Worker | 8326 Kelwood Avenue, Alexandria, LA 71303 | 2020-01-22 |
| 1164904520 | Carissa A Sorenson | Pharmacist | 4448 Jackson St, Alexandria, LA 71303 | 2018-09-02 |
| 1144731027 | Bradly Herman | Counselor | 1450 Peterman Drive, Alexandria, LA 71303 | 2017-10-18 |
| 1669991915 | Rashika Holmes | Counselor | 1538 Chase Dr, Alexandria, LA 71303 | 2017-09-18 |
| 1215466594 | Terraniecya Shepherd | Case Manager/Care Coordinator | 700 Veterans Dr. Apt. 608, Alexandria, LA 71303 | 2017-06-08 |
| 1427587864 | Jason Micheal Lachica | Counselor | 3921 Indpendence Drive Ste 104, Alexandria, LA 71303 | 2017-06-08 |
| 1669929188 | Ryan Knoll | Chiropractor | 5419 Jackson St. Ext. Suite B, Alexandria, LA 71303 | 2016-09-01 |
| 1023464393 | Heart of Hospice, LLC | Hospice Care, Community Based | 1001 Bayou Pl, Alexandria, LA 71303 | 2016-05-05 |
| 1770947764 | Jiquiah White | Counselor | 2016 Innis Dr, Alexandria, LA 71303 | 2016-04-06 |
| Find all providers in zip 71303 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710521257 | Karly Bauer | Specialist | 512 30th Ave E Ste 10, Alexandria, MN 56308-5096 | 2019-10-28 |
| 1063997724 | Women's Health Clinic, Inc | Specialist | 5999 Stevenson Ave Ste 403, Alexandria, VA 22304-3302 | 2018-09-28 |
| 1013458413 | Rebecca Walton | Specialist | 5936 Bangor Dr, Alexandria, VA 22303-2202 | 2017-03-17 |
| 1487107587 | Loudoun Medical Group PC | Specialist | 6355 Walker Ln Ste 303, Suite 303, Alexandria, VA 22310-3247 | 2016-07-26 |
| 1861866410 | Lea Hawkins-fisher | Specialist | 1024 3rd St, Suite 203, Alexandria, LA 71301-8343 | 2015-11-19 |
| 1639581408 | Denise Lee | Specialist | 6824 Deer Run Dr, Alexandria, VA 22306-1123 | 2014-05-28 |
| 1144645912 | Iris Jones | Specialist | 3654 Government St, Suite 7, Alexandria, LA 71302-3324 | 2014-03-03 |
| 1164705539 | Madeline Carmen Hernandez | Specialist | 5838 Brookview Dr, Alexandria, VA 22310-1817 | 2011-09-22 |
| 1134434046 | Gynecare Associates | Specialist | 2807 Duke St, Alexandria, VA 22314-4512 | 2010-08-16 |
| 1962737080 | Ariel O Antezana | Specialist | 3311 Prescott Rd Ste 216, Alexandria, LA 71301-3983 | 2009-10-07 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 71303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.