DR. DENNIS STEPHEN GOODMAN (NPI# 1720169709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720169709 |
| Entity Type | Individual |
| Full Name | DR. DENNIS STEPHEN GOODMAN |
| Credential | DO |
| Practice Address |
715 St Rt Cc Rolla MO 65401 |
| Mailing Address |
Po Box 918 Rolla MO 65402 |
| Practice Telephone | 5733087386 |
| Practice Fax Number | 5733415300 |
| Mailing Fax Number | 5733415300 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-02-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
RSB71 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 241605948 | 05 | |
| MO | RAILROAD MEDICARE | 080052033 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275543282 | Dennis B Goodman | Surgery | 209 Lincoln Ave, Rumford, ME 04276-1853 | 2006-08-09 |
| 1639175011 | Dennis W Goodman | Optometrist | 10513 Silverdale Way Nw, Suite 110, Silverdale, WA 98383-9499 | 2005-06-22 |
| 1235107897 | Dennis A Goodman | Internal Medicine | 10820 N Torrey Pines Rd, La Jolla, CA 92037-1036 | 2006-03-09 |
| Street Address |
715 ST RT CC |
| City | ROLLA |
| State | MO |
| Zip Code | 65401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114007333 | Karene Marie Goodman | Nurse Practitioner | 715 St Rt Cc, Rolla, MO 65401 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
| Find all providers in zip 65401 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538232772 | Randall D. Huss | Family Medicine | 910 W 10th St, Rolla, MO 65401-2904 | 2006-11-16 |
| 1770546665 | Kerr Healthcare Services LLC | Family Medicine | 11851 Arbor Cir, Rolla, MO 65401-7476 | 2006-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164781035 | Carlyn Molstad Kline | Family Medicine | 17 Stonecrest, St. Joseph, MO 64506-3126 | 2012-05-11 |
| 1730346230 | Ltc Consultants LLC | Family Medicine | 16201 Bluegrass Ct, Belton, MO 64012-3342 | 2008-05-21 |
| 1487853750 | Susan E. Pearson, LLC | Family Medicine | 6209 Midrivers Mall Dr, #317, St Charles, MO 63304-1102 | 2007-07-16 |
| 1356476071 | Thomas M Macdonnell | Family Medicine | 665 State Highway J, Marshfield, MO 65706-8253 | 2007-02-22 |
| 1750464723 | Nevada Lee | Family Medicine | 6317 Evanston Ave, Raytown, MO 64133-4929 | 2006-10-23 |
| 1447361977 | Richard O Schamp | Family Medicine | 6255 San Bonita Ave, Saint Louis, MO 63105-3210 | 2006-08-31 |
| 1265546923 | Patricia Sue Inman | Family Medicine | 400 Chesterfield Ctr, Suite 400, Chesterfield, MO 63017-4834 | 2006-08-19 |
| 1831152370 | Jeffery Alan Kerr | Family Medicine | 1000 Gw Ln, Waynesville, MO 65583-2339 | 2006-04-07 |
| 1194796490 | Donald Charles Walkenhorst | Family Medicine | 759 Lafeil Dr, Manchester, MO 63021-7067 | 2006-01-27 |
| 1770568164 | Henry D. Petry | Family Medicine | 931 E 32nd St, Joplin, MO 64804-2808 | 2005-12-08 |
| Find all providers with the same taxonomy | ||||
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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.