JACOB DILLON GOODEN (NPI# 1023622529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023622529 |
| Entity Type | Individual |
| Full Name | JACOB DILLON GOODEN |
| Credential | PA-C |
| Practice Address |
1001 Sam Perry Blvd Fredericksburg VA 22401-4453 |
| Mailing Address |
30 Carriage Hill Ln Fredericksburg VA 22407-2402 |
| Practice Telephone | 5407411100 |
| Mailing Telephone | 3366828615 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1001 SAM PERRY BLVD |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-4453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730185398 | Torrey Hawley | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2005-06-28 |
| 1508478462 | Sabrina Brandi Cervantez | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-08-20 |
| 1275144297 | Emily Burger | Pharmacist | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-08-13 |
| 1144839762 | Briana Lafuria | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-07-29 |
| 1831724301 | Yaru Chen | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-03-05 |
| 1922631456 | Christopher Barnes | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-02-12 |
| 1649803172 | Richard L Derrick | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-02-12 |
| 1851930838 | Markia Stewart Dudley | Nurse Practitioner | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-12-23 |
| 1861030637 | Amalea Suzette Gray | Pharmacist | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-12-12 |
| 1194363929 | Lori Beth Feldman | Pharmacist | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265907521 | Meghan Marie Ellden | Physician Assistant | 125 Olde Greenwich Dr Ste 220, Fredericksburg, VA 22408-4010 | 2018-10-12 |
| 1578912424 | Jenna Kollat | Physician Assistant | 1101 Sam Perry Blvd Ste 211, Fredericksburg, VA 22401-4465 | 2016-06-10 |
| 1386090561 | Mukul Mallick | Physician Assistant | 15 S Gateway Dr Ste 101, Fredericksburg, VA 22406-1231 | 2016-05-06 |
| 1457690489 | James Michael Crawford | Physician Assistant | 1031 S State Highway 16, Fredericksburg, TX 78624-4472 | 2013-02-12 |
| 1023378833 | Juliet Dameron | Physician Assistant | 1601 Olde William Street, Suite B, Fredericksburg, VA 22401-5525 | 2012-05-25 |
| 1124399951 | Chelsea Marie Garfield | Physician Assistant | 3 Rosemont Ct, Fredericksburg, VA 22405-6140 | 2012-01-25 |
| 1154622967 | Elizabeth Marie Greene | Physician Assistant | Bettermed Urgent Care, 10004 Southpoint Pkwy, Fredericksburg, VA 22407 | 2010-11-10 |
| 1295986248 | Megan Lynn Staudt | Physician Assistant | 140 Industrial Loop, Suite 100, Fredericksburg, TX 78624-5456 | 2008-10-08 |
| 1083734578 | Michelle Ann O'connor | Physician Assistant | 15 S Gateway Dr, Suite 101, Fredericksburg, VA 22406-1231 | 2007-03-30 |
| 1043346992 | Natalie Gergler | Physician Assistant | 2216 Princess Anne St Ste 204, Fredericksburg, VA 22401-3300 | 2007-02-26 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
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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.