Deserae J Goble MD PC
NPI 1407232903ActiveOrganization· Family Medicine· Logan, UT
Family Medicine in Logan, Utah, registered in NPPES in August 2015. The authorized official on file is Deserae Goble, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1407232903 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 6, 2015 |
| Last updated in NPPES | Aug 31, 2021 |
| Certified by provider | Aug 31, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 5010200-1205 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
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