JACK GOODE (NPI# 1174551550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174551550 |
| Entity Type | Individual |
| Full Name | JACK GOODE |
| Credential | M.D. |
| Practice Address |
18111 Prince Philip Dr T-20 Olney MD 20832-1513 |
| Mailing Address |
4110 Aspen Hill Rd Suite 200 Rockville MD 20853-2853 |
| Practice Telephone | 3017743400 |
| Mailing Telephone | 3014385150 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
D0040434 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 007235739 | 05 | |
| VA | 010075122 | 05 | |
| VA | 010072182 | 05 | |
| VA | 010072492 | 05 | |
| VA | 010075465 | 05 | |
| VA | 0185451800 | 05 | |
| DC | 024780600 | 05 | |
| VA | 010075050 | 05 | |
| VA | 007235721 | 05 | |
| VA | 007238177 | 05 | |
| VA | 010075025 | 05 | |
| VA | 007235747 | 05 |
| Street Address |
18111 PRINCE PHILIP DR T-20 |
| City | OLNEY |
| State | MD |
| Zip Code | 20832-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447253679 | Susanne T Woodlan | Specialist | 18111 Prince Philip Dr, Ste 111, Olney, MD 20832-1503 | 2005-05-23 |
| 1952787400 | Lera Salvatierra Ison | Nurse Practitioner | 18111 Prince Philip Dr, Ste 300, Olney, MD 20832-1513 | 2015-08-07 |
| 1043691884 | Sherry Hood Dulling | Nurse Practitioner | 18111 Prince Philip Dr, Suite 300, Olney, MD 20832-1507 | 2015-06-17 |
| 1518359066 | The Neurology Clinic of Washington | Clinical Nurse Specialist | 18111 Prince Philip Dr, Suite 124, Olney, MD 20832-1513 | 2015-02-20 |
| 1497150411 | Michele Parent | Physical Therapist | 18111 Prince Philip Dr, Suite 125, Olney, MD 20832-1513 | 2014-11-03 |
| 1487089819 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 18111 Prince Philip Dr, Suite 221, Olney, MD 20832 | 2013-09-04 |
| 1346506219 | Mclmhp Inc. | Clinic/Center | 18111 Prince Philip Dr, Suite 312, Olney, MD 20832-1513 | 2012-04-05 |
| 1881963544 | Phs Orhthopaedics Olney | General Acute Care Hospital | 18111 Prince Philip Dr, Suite 208, Olney, MD 20832-1513 | 2011-12-23 |
| 1568745750 | Allyson Deborah Bull | Audiologist | 18111 Prince Philip Dr, Suite 224, Olney, MD 20832-1513 | 2011-09-23 |
| 1194023234 | Ashraf M. Sufi, M.d. LLC | Internal Medicine | 18111 Prince Philip Dr, Suite 202, Olney, MD 20832-1513 | 2011-03-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443532 | Ludmila Costenco | Behavior Technician | 18218 Fox Chase Cir, Olney, MD 20832 | 2018-07-02 |
| 1912422874 | Shannon Denham Nguy | Nurse Practitioner | 18109 Prince Philip Dr Ste 300, Olney, MD 20832 | 2017-08-11 |
| 1578092904 | Rodney John Bohlmann | Naturopath | 17517 Queen Elizabeth Drive, Olney, MD 20832 | 2017-06-08 |
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1437547684 | Cynthia Ann Cook | Social Worker | 18006 Vintage River Terrace, Olney, MD 20832 | 2014-12-22 |
| 1598165334 | Gedion Haile | Pharmacist | 3110 Onley Sandy Spring Rd, Onley, MD 20832 | 2014-08-29 |
| 1285047902 | Melanie Ann Grady | Family Medicine | 18109 Prince Phillip Drive, Suite B200, Olney, MD 20832 | 2014-06-10 |
| 1063847267 | Mari Nako Tchantcho | Home Health Aide | 17149 Moss Side Lane, Olney, MD 20832 | 2013-09-06 |
| 1033558358 | Emily Sue Browning | Dentist | 3416 Olandwood Court, Suite 205, Suite 205, Olney, MD 20832 | 2013-06-19 |
| 1487093167 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 3414 Olandwood Court, Olney, MD 20832 | 2013-06-17 |
| Find all providers in zip 20832 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821138538 | Chikaodili I Logie | Radiology | 18314 Leedstown Way, Olney, MD 20832-3110 | 2007-02-08 |
| 1154365328 | James M Mccabe | Radiology | 18103 Prince Philip Dr, Olney, MD 20832-1514 | 2006-06-16 |
| 1720203144 | Olney Hamilton Hospital District | Radiology | 901 W Hamilton St, Olney, TX 76374-1725 | 2007-04-13 |
| 1538299292 | Larry Bernstein | Radiology | 18111 Prince Philip Dr, T-20, Olney, MD 20832-1513 | 2007-03-06 |
| 1417971078 | Richard O Odero | Radiology | 18111 Prince Philip Dr, T-20, Olney, MD 20832-1513 | 2006-07-27 |
| 1861420861 | Ajay S Sufi | Radiology | 18111 Prince Philip Dr, T-20, Olney, MD 20832-1513 | 2006-06-29 |
| 1215965165 | Mukul Das | Radiology | 18111 Prince Philip Dr, Sute T-20, Olney, MD 20832-1513 | 2006-06-29 |
| 1447212840 | Drs Korsower & Pion Radiology Pa | Radiology | 18101 Prince Philip Drive, Montgomery General Hospital, Olney, MD 20832-1514 | 2006-04-03 |
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| 1326648346 | Physician Imaging of Washington Hospital Center LLC | Radiology | 3202 Tower Oaks Blvd Ste 120, Rockville, MD 20852-4263 | 2020-10-28 |
| 1861997678 | Harford X-ray Services LLC | Radiology | 615 W Macphail Rd Ste 106b, Bel Air, MD 21014 | 2018-03-26 |
| 1841703410 | Los Robles Radiologic Associates | Radiology | 7903 Terrapin Ct, Pikesville, MD 21208-3126 | 2017-11-06 |
| 1861905432 | Los Robles Radiologic Associates | Radiology | 9712 W Bexhill Dr, Kensington, MD 20895-3530 | 2017-11-06 |
| 1467993386 | Iv Radiology Medical Group | Radiology | 10000 Town Center Ave, Apt 244, Columbia, MD 21044-5418 | 2017-03-10 |
| 1962854166 | Michael Louis Sherman | Radiology | 11304 John Carroll Rd, Owings Mills, MD 21117-1658 | 2016-07-12 |
| 1346604295 | Physician Imaging of Washington Hospital Center, LLC | Radiology | 13950 Bradywine Road, Brandywine, MD 20613 | 2016-04-07 |
| 1700253473 | Peter Choyke | Radiology | Molecular Imaging Program Nci, Building 10, Room B3b69f, Bethesda, MD 20892-0001 | 2015-08-28 |
| 1235510983 | David Jinkyu Lee | Radiology | 601 N Caroline St # 3251, Baltimore, MD 21287-0006 | 2015-06-17 |
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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.