MR. JESSE LEE GOODMAN (NPI# 1699843342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699843342 |
| Entity Type | Individual |
| Full Name | MR. JESSE LEE GOODMAN |
| Credential | PA-C |
| Practice Address |
1515 Ne Lawrie Tatum Rd Lawton OK 73507-3002 |
| Practice Telephone | 5803545100 |
| Practice Fax Number | 5803545105 |
| Mailing Telephone | 5803545100 |
| Mailing Fax Number | 5803545105 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2013-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2244 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457415366 | Jesse Lyle Goodman | Internal Medicine | Wramc, Building 2, Department of Medicine, 6900 Georgia Ave, Washington, DC 20307-5001 | 2006-12-22 |
| 1922011246 | Jesse Adam Goodman | Psychiatry & Neurology | 38 Church St, Suite 101, Lenox, MA 01240-2525 | 2006-08-15 |
| 1609248202 | Jesse Goodman | Nurse Practitioner | 17782 Cowan Ste A, Irvine, CA 92614-6041 | 2015-10-22 |
| Street Address |
1515 NE LAWRIE TATUM RD |
| City | LAWTON |
| State | OK |
| Zip Code | 73507-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710982160 | Greg Alan Ketcher | Optometrist | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3002 | 2005-06-14 |
| 1295332765 | Dean Thompson | Case Manager/Care Coordinator | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-10-07 |
| 1447863832 | Susan Browning | Registered Nurse | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-08-26 |
| 1144831983 | Christopher Anthony | Radiologic Technologist | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-08-14 |
| 1851914782 | Emily Jean Mcintosh | Registered Nurse | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-27 |
| 1215559828 | Miaka Huynh | Pharmacist | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-18 |
| 1568084671 | Janet Laura Tippeconnic | Technician, Other | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-12 |
| 1598387698 | Edward Jerome Tahhahwah IIi | Technician, Other | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-12 |
| 1861014961 | Amber Karty | Technician, Other | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-12 |
| 1689293227 | Stephanie Young | Registered Nurse | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720619935 | Kori Wren Wiegmann | Registered Nurse | 1515 Nw Lawrie Tatum Road, Lawton, OK 73507 | 2020-01-28 |
| 1013424027 | Liane Jacobson | Registered Nurse | 1515 Laurie Tatum Road, Adult Care Clinic 2, Lawton, OK 73507 | 2017-12-29 |
| 1649727041 | Rachel Ayala | Dietitian, Registered | 2811 Nw Hilltop Dr, Lawton, OK 73507 | 2016-09-02 |
| 1811370471 | William S, Davies, M.d., Inc. | Psychiatric Residential Treatment Facility | 1302 N, W, Lake Ave, Lawton, OK 73507 | 2015-07-01 |
| 1538554894 | Ashlee A Haugen-lewis | Behavioral Analyst | 4121 W Gore, Lawton, OK 73507 | 2015-04-03 |
| 1003188970 | Jenny Rae Mohon | Registered Nurse | 1515 North East Lawrie Tatum Road, Usphs Lawton Indian Hospital, Lawton, OK 73507 | 2012-02-07 |
| 1558548578 | Dawn M Griffith | Registered Nurse | 1515 Lawrie Tatum Dr., Lawton, OK 73507 | 2008-01-22 |
| 1275605172 | Judy Weiss | Pharmacist | 524 Lawrie Tatum Rd, Lawton, OK 73507 | 2006-11-15 |
| 1790895894 | William Spalding Davies | Psychiatry & Neurology | 1302 Lake Ave, Lawton, OK 73507 | 2006-08-30 |
| 1275646374 | Phillip Lynn Aday | Dentist | 1116 Nw Arlington, Lawton, OK 73507 | 2006-08-16 |
| Find all providers in zip 73507 | ||||
| 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 |
|---|---|---|---|---|
| 1780967257 | Erin Belanger Glomset | Physician Assistant | 5606 Sw Lee Blvd Ste 201, Lawton, OK 73505-9651 | 2011-09-21 |
| 1871888628 | Brian Andrew Janek | Physician Assistant | 5050 Sw Lee Blvd, Suite 2, Lawton, OK 73505 | 2011-06-09 |
| 1356358501 | Hope King | Physician Assistant | 1302 Nw Lake Ave, Lawton, OK 73507-6577 | 2006-08-01 |
| 1033116363 | Thomas Lee Mills | Physician Assistant | 3106 Nw Arlington Ave, Lawton, OK 73505-6123 | 2005-07-01 |
| 1669963575 | Catherine H Phipps | Physician Assistant | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2018-05-25 |
| 1437542198 | Briana Farmer | Physician Assistant | 4920 Sw Lee Blvd, Lawton, OK 73505-8339 | 2015-03-05 |
| 1326387739 | Nancy E Varkey | Physician Assistant | 110 Nw 31st St Fl 2, Lawton, OK 73505-6100 | 2013-02-05 |
| 1205108222 | Christopher Aquies Taylor | Physician Assistant | 4301 Wilson St, Lawton, OK 73503-4472 | 2012-02-07 |
| 1114239795 | Oklahoma Emergency Services PC | Physician Assistant | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2010-07-12 |
| 1598830200 | Leonard Sims Mcneil | Physician Assistant | 901 Sw Goodyear Blvd, Lawton, OK 73505-9755 | 2006-11-21 |
| Find all providers in LAWTON | ||||
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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.