JACK R GOODMAN (NPI# 1922110105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922110105 |
| Entity Type | Individual |
| Full Name | JACK R GOODMAN |
| Credential | MD |
| Practice Address |
200 Henry Clay Ave New Orleans LA 70118-5720 |
| Practice Telephone | 5048949432 |
| Practice Fax Number | 5048969432 |
| Mailing Telephone | 5048969432 |
| Mailing Fax Number | 5048949432 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 010553 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1133922 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710038161 | Jack Andrew Goodman | Anesthesiology | 4515 Poplar Ave Ste 426, Memphis, TN 38117-7517 | 2007-01-14 |
| 1831292051 | Jack Goodman | Neurological Surgery | 9 Livingston St, Ste 5, Poughkeepsie, NY 12601 | 2006-09-06 |
| Street Address |
200 HENRY CLAY AVE |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70118-5720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073505632 | Thomas H Carson | Pathology | 200 Henry Clay Ave, Children's Hospital- Department of Pathology, New Orleans, LA 70118-5720 | 2005-08-19 |
| 1255932182 | Children's Hospital | Ambulance | 200 Henry Clay Ave, New Orleans, LA 70118-5798 | 2020-11-06 |
| 1831703768 | Olivia Dejean | Physician Assistant | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-09-08 |
| 1821600149 | Kristen Clement Casey | Nurse Practitioner | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-08-18 |
| 1093326407 | Devon Relle | Nurse Practitioner | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-08-11 |
| 1710507389 | Hiba Elaasar | Student in an Organized Health Care Education/Training Program | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-04-23 |
| 1598385684 | Heather Cleveland | Physician Assistant | 200 Henry Clay Ave, New Orleans, LA 70118-5798 | 2020-04-20 |
| 1730717158 | Ryan Gill | Student in an Organized Health Care Education/Training Program | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-03-31 |
| 1336777390 | Megan Burke | Student in an Organized Health Care Education/Training Program | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-03-27 |
| 1760010755 | Abby Walker | Nurse Practitioner | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791831 | The Administrators of The Tulane Educational Fund | Clinic/Center | 200 Broadway Avenue, Suite 108, New Orleans, LA 70118 | 2020-08-19 |
| 1730674557 | Louisiana Department of Health, Department of Health and Hospitals | Skilled Nursing Facility | 612 Henry Clay Ave., New Orleans, LA 70118 | 2018-06-25 |
| 1588153167 | Kimberly Felicia Fields | Behavior Technician | 733 Dante St., New Orleans, LA 70118 | 2018-05-09 |
| 1275033029 | Antonia Jennice Hollins | Behavior Technician | 733 Dante, New Orleans, LA 70118 | 2018-02-19 |
| 1922521467 | Amy Mcdonald | Specialist/Technologist | 2950 Ben Weiner Dr., Tulane Univ., Athletic Training Rm, 1st Floor, New Orleans, LA 70118 | 2017-07-17 |
| 1760910848 | Tyler Tunnell | Specialist/Technologist | James Wilson Center, 333 Ben Weiner Drive, New Orleans, LA 70118 | 2017-06-01 |
| 1538692801 | Shneitha Beasley | Counselor | 2619 Leonidas St, New Orleans, LA 70118 | 2017-04-04 |
| 1467826966 | Ethan Alan Solger | Specialist/Technologist | 333 James W Wilson Jr Center, New Orleans, LA 70118 | 2015-11-20 |
| 1225402878 | Heather Ravner | Student in an Organized Health Care Education/Training Program | Ben Weiner Drive, James W. Wilson Jr. Center, New Orleans, LA 70118 | 2015-11-19 |
| 1558735142 | Albert Charles Lindon IIi | Specialist/Technologist | 333 Ben Weiner Dr, New Orleans, LA 70118 | 2015-11-19 |
| Find all providers in zip 70118 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336436252 | Omer Raheem | Urology | 3525 Prytania St Ste 614, New Orleans, LA 70115 | 2011-06-29 |
| 1033355995 | Nathan Samuel Wexler | Urology | 6050 Annunciation St, New Orleans, LA 70118-5707 | 2008-12-25 |
| 1932375995 | Kathleen Elizabeth Walsh | Urology | 1310 Henry Clay Ave, New Orleans, LA 70118-6009 | 2008-04-30 |
| 1235221078 | Erik Peter Castle | Urology | 1415 Tulane Ave Fl 3, New Orleans, LA 70112-2600 | 2006-09-29 |
| 1982615217 | Valentine A. Earhart | Urology | 1129 Soniat St, New Orleans, LA 70115-2917 | 2006-08-11 |
| 1407832298 | Susan Mcsherry | Urology | 1445 2nd St, New Orleans, LA 70130-5726 | 2005-12-22 |
| 1730188533 | Thomas L Ewing | Urology | 3434 Prytania St Ste 450, New Orleans, LA 70115 | 2005-07-14 |
| 1861497075 | Ralph Charles Sagrera | Urology | 29 Fairway Oaks Drive, New Orleans, LA 70131 | 2005-06-15 |
| 1144875956 | Ayad Abed Yousif | Urology | 1415 Tulane Ave, New Orleans, LA 70112-2600 | 2019-08-08 |
| 1962899633 | Kristen Elizabeth Gurtner | Urology | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2015-04-21 |
| Find all providers in NEW ORLEANS | ||||
| City | NEW ORLEANS |
| Zip Code | 70118 |
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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.