DR. BRYAN JOSEPH GOODMAN (NPI# 1366789372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366789372 |
| Entity Type | Individual |
| Full Name | DR. BRYAN JOSEPH GOODMAN |
| Credential | PHARM D |
| Practice Address |
15 Laurel Canyon Village Cir 118 Canton GA 30114-4469 |
| Practice Telephone | 7704793711 |
| Practice Fax Number | 7704793777 |
| Mailing Telephone | 7704793711 |
| Mailing Fax Number | 7704793777 |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2013-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH024776 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316350168 | Bryan Goodman | Military Health Care Provider | Bldg #1058, Mcbh Kaneohe Bay, HI 96863 | 2014-06-10 |
| 1801386610 | Bryan Nicholas Goodman | Student in an Organized Health Care Education/Training Program | 1775 Grand Concourse, Bronx, NY 10453-8202 | 2018-05-16 |
| Street Address |
15 LAUREL CANYON VILLAGE CIR 118 |
| City | CANTON |
| State | GA |
| Zip Code | 30114-4469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356688063 | Karen Johnston | Pharmacist | 15 Laurel Canyon Village Cir, Suite 118, Canton, GA 30114-4469 | 2013-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1467084343 | Syed Ashraf Ali Shah | Pharmacist | 385 Westbourne Ct, Canton, MI 48188-4718 | 2020-02-07 |
| 1427680503 | Gracy Mathai-mathews | Pharmacist | 770 Pheasant Woods Dr, Canton, MI 48188-5224 | 2020-02-06 |
| 1962059378 | Catherine Lynn Denner | Pharmacist | 330 Oak Hill Ln, Canton, GA 30115-5433 | 2019-08-20 |
| 1427601806 | Tarek Mazloum | Pharmacist | 3815 Herbey St, Canton, MI 48188-2421 | 2019-07-24 |
| 1013473925 | Yen Do Ruiz | Pharmacist | 41460 Haggerty Circle South, Canton, MI 48188 | 2019-02-15 |
| 1063978260 | Jordan Richard Wanner | Pharmacist | 4615 Middlebranch Ave Ne, Canton, OH 44705-2960 | 2019-02-13 |
| 1861972333 | Brittany Carin Yu | Pharmacist | 2512 Tuscarawas St W, Canton, OH 44708-4702 | 2018-08-15 |
| 1598256364 | Austin Tull | Pharmacist | 2260 Holly Springs Pkwy Ste 180, Canton, GA 30115-9580 | 2018-05-28 |
| 1518491513 | Jerry Sherwin Vidis | Pharmacist | 41092 Northwind Dr, Canton, MI 48188-3115 | 2017-04-17 |
| Find all providers in CANTON | ||||
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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.