Amber Lynne Goodman (NPI# 1013305895, PAC ID# 9537489109) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1013305895 |
| PAC ID by PECOS | 9537489109 |
| Professional Enrollment ID | I20171030002038 |
| Full Name | Amber Lynne Goodman |
| Organization Legal Name | ST. DOMINIC HOSPITAL MEDICINE LLC |
| Address |
969 Lakeland Dr Jackson MS 39216-4606 |
| Phone Number | 6012004644 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 5597034348 |
| Number of Group Practice Members | 60 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 969 Lakeland Dr, Jackson, MS 39216-4606 | 6012004644 | ST. DOMINIC HOSPITAL MEDICINE LLC |
| Organization Legal Name | ST. DOMINIC HOSPITAL MEDICINE LLC |
| Physicians | 55 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gabriel M Zevallos | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jonathan Davison Reves | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle Hughes | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| James E Roberts Jr. | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jenna Elizabeth Clark | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| David Shrock | Physician Assistant | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Brian Lee Burgemaster | Physician Assistant | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Lajuana Yevette Newton | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Shinita R Dudley | Family Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Charles Butler | Hospitalist | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Street Address |
969 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip | 39216-4606 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Smith | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Gabriel M Zevallos | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Deidra Thompson | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jonathan Davison Reves | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jana P Cline | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle Hughes | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| James E Roberts Jr. | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Kathryn Nicholas | Diagnostic Radiology | Lakeland Radiologists, Pa | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle V Taylor | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jenna Elizabeth Clark | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark O Rester | Psychiatry | 1225 N State St, Jackson, MS 39216 | |
| Jasmine Martin Smith | Physical Therapy | Central Mississippi Civic Improvement Association, Inc | 3502 W Northside Dr, Jackson, MS 39216 |
| Lula Johnson | Nurse Practitioner | Central Mississippi Civic Improvement Association, Inc | 3502 W Northside Dr, Jackson, MS 39216 |
| Olivia Mccay | Registered Dietitian Or Nutrition Professional | Nutrition Systems Wellness LLC | 603 Duling Ave, Suite 207, Jackson, MS 39216-4009 |
| Nosratollah Ghaemmaghami | Internal Medicine | 381 Medical Dr, Jackson, MS 39216-4118 | |
| Julie P Wyatt | Dermatology | 3000 Old Canton Rd, Suite 430, Jackson, MS 39216-4225 | |
| Nancy H Goldman | Certified Clinical Nurse Specialist (cns) | 3000 Old Canton Rd, Suite 465, Jackson, MS 39216-4225 | |
| Louis Wise Jr. | Dermatology | 3000 Old Canton Rd, Suite 430, Jackson, MS 39216-4225 | |
| Thomas H Cabell | Ophthalmology | 3000 Old Canton Rd, Suite 405, Jackson, MS 39216-4234 | |
| Albert T Williams | Ophthalmology | A.terrel Williams, Md, Pllc | 3000 Old Canton Rd, Suite 305, Jackson, MS 39216-4245 |
| Find all physicians in zip 39216 | |||
| City | JACKSON |
| Zip Code | 39216 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | JACKSON + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Amber Lynne Goodman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.