DR. ROBERT L GODDARD JR. (NPI# 1982658886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982658886 |
| Entity Type | Individual |
| Full Name | DR. ROBERT L GODDARD JR. |
| Credential | MD |
| Practice Address |
817 W Rosewood Dr Bloomington IN 47404-1849 |
| Practice Telephone | 8129292952 |
| Mailing Telephone | 8129292952 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
01062280A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BG1230452 | 01 | |
| TX | TEXAS LICENSE | L3661 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508828237 | Robert C Goddard | Psychologist | 66 Prospect St, Manchester, NH 03104-3506 | 2006-04-06 |
| Street Address |
817 W ROSEWOOD DR |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47404-1849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
| 1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
| 1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
| 1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
| 1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
| 1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
| 1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
| Find all providers in zip 47404 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689842262 | James Scott Frasure | Emergency Medicine | 4030 W Breezewood Ct, Bloomington, IN 47404-9132 | 2008-02-15 |
| 1861703100 | The Vein Specialists, LLC | Emergency Medicine | 3302 Gerig Dr, Suite 100, Bloomington, IL 61704-6365 | 2010-07-01 |
| 1548340409 | Kevin T. Moore | Emergency Medicine | 601 W 2nd St, Bloomington, IN 47403-2317 | 2006-10-16 |
| 1841211042 | Jeanette Hammerstein | Emergency Medicine | 4011 S Monroe Medical Park Blvd, Bloomington, IN 47403-8000 | 2006-07-22 |
| 1023045606 | Richard Sabbun | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-27 |
| 1497782700 | Douglas Ward | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-26 |
| 1851390504 | Joel Nelson | Emergency Medicine | 550 S Landmark Ave, Bloomington, IN 47403-3239 | 2005-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871217 | Nw Indiana Ep, LLC | Emergency Medicine | 7904 Cabela Dr, Hammond, IN 46324-2950 | 2020-01-30 |
| 1801383278 | Midwest Emergency Medicine, Inc. | Emergency Medicine | 520 S 7th Street, Er, Vincennes, IN 47591-1038 | 2018-04-20 |
| 1285994434 | Aaron Brooks Crofoot | Emergency Medicine | 229 W North Shore Dr, South Bend, IN 46617-1142 | 2012-05-22 |
| 1831290956 | Suzanne M Coleman | Emergency Medicine | 3124 E State Blvd Ste 2b, Fort Wayne, IN 46805-4763 | 2006-09-25 |
| 1194772681 | Paula Lange | Emergency Medicine | 3252 Tantara Bnd, Carmel, IN 46032-8733 | 2006-05-28 |
| 1295796985 | Thomas S Spencer | Emergency Medicine | 104 E Culver Rd, Suite 103, Knox, IN 46534-2216 | 2006-03-31 |
| 1609844166 | Joseph V Lazzara | Emergency Medicine | 8633 N State Road 550, Bruceville, IN 47516-6096 | 2006-03-10 |
| 1427048099 | Mark M Walsh | Emergency Medicine | 801 E Lasalle, Emergency Department, South Bend, IN 46617-2814 | 2005-10-25 |
| 1417558271 | Daviess County Hospital | Emergency Medicine | 1314 E Walnut St, Washington, IN 47501-2860 | 2020-11-06 |
| 1851816656 | Lacey Diane Maul | Emergency Medicine | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2017-08-14 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47404 |
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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.