ELLIOT GOODENOUGH (NPI# 1871973313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871973313 |
| Entity Type | Individual |
| Full Name | ELLIOT GOODENOUGH |
| Credential | MD, PHD |
| Practice Address |
1427 Vine St Philadelphia PA 19102-1031 |
| Mailing Address |
1427 Vine St Fl 4 Philadelphia PA 19102-1031 |
| Practice Telephone | 2157622530 |
| Mailing Telephone | 2157622530 |
| Mailing Fax Number | 2157622531 |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2020-04-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD460791 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 103315777 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 Callowhill St Ste 101, Philadelphia, PA 191233658 | 2158258220 | 2677652325 |
| 125 S 9th St, Philadelphia, PA 191075125 | 2155924500 | 2155924326 |
| 1900 N 9th St Ste 104, Philadelphia, PA 191222028 | 2157656690 | 2157656694 |
| 3401 North Broad Street 1st Floor, Suite D101, Philadelphia, PA 19140 | 2157317144 | 2677652325 |
| 412 W Lehigh Ave, Philadelphia, PA 191333148 | 2152799666 | 2152799674 |
| 5675 N Front St, Philadelphia, PA 191202719 | 2152799666 | 2152799674 |
| Street Address |
1427 VINE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19102-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063410793 | Sara L. Allen | Nurse Practitioner | 1427 Vine St, 5th Floor, Philadelphia, PA 19102-1031 | 2005-07-07 |
| 1316312788 | Jennifer Thompson | Nurse Practitioner | 1427 Vine St, 2nd Floor, Philadelphia, PA 19102-1031 | 2015-12-10 |
| 1528477098 | Jared Goldman | Psychologist | 1427 Vine St, Philadelphia, PA 19102-1031 | 2014-08-08 |
| 1871925214 | Nicola D'souza | Social Worker | 1427 Vine St, 2nd Floor, Philadelphia, PA 19102-1031 | 2013-08-08 |
| 1497187835 | Sarah Baky | Social Worker | 1427 Vine St, 2nd Floor, Philadelphia, PA 19102-1031 | 2013-08-08 |
| 1942549365 | Richard Baccare | Social Worker | 1427 Vine St, Philadelphia, PA 19102-1031 | 2013-02-05 |
| 1912285065 | Shara Ilyse Epstein | Internal Medicine | 1427 Vine St, 2nd Floor, Philadelphia, PA 19102-1031 | 2011-07-22 |
| 1699062174 | Laura Panarey | Internal Medicine | 1427 Vine St, Philadelphia, PA 19102-1031 | 2011-07-05 |
| 1205157484 | Behnaz Rouhani | Ophthalmology | 1427 Vine St, Philadelphia, PA 19102-1031 | 2010-06-22 |
| 1164755385 | Eva M Greenberg | Psychologist | 1427 Vine St, 8th Floor, Philadelphia, PA 19102-1031 | 2009-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650847 | Alexandre Mason Sharma | Student in an Organized Health Care Education/Training Program | 200 N 16th St Apt 1318, Philadelphia, PA 19102 | 2019-06-29 |
| 1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
| 1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
| 1245898170 | Parth Javia | Internal Medicine | 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-05 |
| 1588120968 | John Granger II | Social Worker | 1500 Market St. 12th Floor Suite 75, Philadelphia, PA 19102 | 2019-02-11 |
| 1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
| 1770076465 | Sarthi Dalal | Internal Medicine | 245 N 15th St, Fl 6, Ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1255824033 | Joyce Nimo-boampong | Internal Medicine | Drexel University College of Medicine, 245 N 15th St, 6th Floor,ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1134625692 | Emma Rose Gormley | Social Worker | 1601 Walnut St Ste 1516, Philadelphia, PA 19102 | 2018-04-03 |
| 1851808497 | Sunish Shah | Pharmacist | 230 N Broad St, Philadelphia, Pa 19102, Philadelphia, PA 19102 | 2018-01-04 |
| Find all providers in zip 19102 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| 1225648140 | Action Health Centers Inc | Family Medicine | 1006 W Lehigh Ave Ste 200, Philadelphia, PA 19133-1640 | 2020-08-05 |
| 1285289876 | Visiting Doctors Inc | Family Medicine | 2338 S Broad St Ste 1, Philadelphia, PA 19145-4450 | 2019-08-09 |
| 1770137218 | Health Care At Northeast Philadelphia LLC | Family Medicine | 3353 Cottman Avenue, Philadelphia, PA 19149-1603 | 2019-08-01 |
| 1679131585 | Aria Health Physician Services | Family Medicine | 3998 Red Lion Rd Ste 204, Philadelphia, PA 19114-1440 | 2019-06-05 |
| 1689232597 | Aria Health Physician Services | Family Medicine | 5000 Frankford Ave Ste 1, Philadelphia, PA 19124-2620 | 2019-06-05 |
| 1174096432 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 2300 W Master St Ste 109b, Philadelphia, PA 19121-4739 | 2019-01-09 |
| 1679043152 | Prevention Point Philadelphia | Family Medicine | 2913-15 Kensington Ave, Philadelphia, PA 19134-3016 | 2018-11-28 |
| 1700362266 | Wes Corporation | Family Medicine | 5000 N 13th St, Philadelphia, PA 19141-3533 | 2018-07-17 |
| 1376046508 | Philly Medical and Rehab Associates | Family Medicine | 6401 Rising Sun Ave, Philadelphia, PA 19111-5228 | 2018-03-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19102 |
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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.