MAHALIA LEONTINE GOODMAN (NPI# 1275169088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275169088 |
Entity Type | Individual |
Full Name | MAHALIA LEONTINE GOODMAN |
Credential | EYE SPECIALIST |
Practice Address |
301 Andrews Ave Fort Rucker AL 36362 |
Practice Telephone | 8002617193 |
Practice Fax Number | 3342557710 |
Mailing Telephone | 8002617193 |
Mailing Fax Number | 3342557710 |
Enumeration Date | 2020-03-13 |
Last Update Date | 2020-03-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 156FX1202X |
Technician/Technologist Specialization: Optometric Technician |
Eye and Vision Services Providers |
Street Address |
301 ANDREWS AVE |
City | FORT RUCKER |
State | AL |
Zip Code | 36362 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407845589 | Craig Brian Collier | Preventive Medicine | 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2005-10-20 |
1225638059 | Mary Sue Mercer | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-10-30 |
1619577673 | Reagan Alanee Jacobs | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-10-29 |
1417556424 | Edwin Brint Hollis | Physical Medicine & Rehabilitation | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-10-21 |
1134746506 | Daniel William Jones | Physical Therapy Assistant | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-07-01 |
1801429493 | Debra D Davis | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-02-21 |
1669004131 | Shelby C Davis | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2020-02-12 |
1407488067 | Bethany Neve | Registered Nurse | 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2020-02-11 |
1851923601 | Kevin Charles Ottiano | Emergency Medical Technician, Basic | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-02-10 |
1801426143 | Mason Webb Sauerwein | Technician, Other | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-01-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
Find all providers in zip 36362 |
Taxonomy Code | 156FX1202X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optometric Technician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174001861 | Eric Rhodes II | Technician/Technologist | Lyster Army Health Cinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2018-08-03 |
1861956823 | Katherine Lambeth | Technician/Technologist | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-01-24 |
1356871206 | Shandy Danielle Hoeffer | Technician/Technologist | Building 301 Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-06-14 |
1720449473 | Danielle Van Winkle | Technician/Technologist | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-03-09 |
1225412026 | Amanda Taylor | Technician/Technologist | Bldg 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2015-07-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609810407 | Jennifer Mcwhorter Elgin | Technician/Technologist | 619 19th Street South, Birmingham, AL 35233 | 2006-06-15 |
City | FORT RUCKER |
Zip Code | 36362 |
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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.