Individual provider Active NPI

Amy Reed Goss, M.D.

  • Gynecology Physician
  • Carrollton, GA
National Provider Identifier
1023301660
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
074196 Issued in GA
Practice address
109 Professional PL
Carrollton, GA 30117-3862
Phone
(770) 834-0170
Fax
(770) 214-1546
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 074196 GA Primary

Addresses

Primary practice location

109 Professional PL
Carrollton, GA 30117-3862

Mailing address

119 Ambulance Dr 202
Carrollton, GA 30117-3857
Phone (770) 838-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112000370 GA Practitioner - Obstetrics/Gynecology 9133365356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

690 Dallas Hwy
Villa Rica, GA 30180-1263

690 Dallas Hwy 207a
Villa Rica, GA 30180-1263
Phone (770) 456-3646

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

706 Dixie St
Carrollton, GA 30117-3819

Hospital & facility affiliations

  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
074196GAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc CurrentSince Jan 4, 2015 Accepting new patients
West Georgia Obstetrics & Gynecology P.C. Gynecology CurrentSince Jul 20, 2015 Accepting new patients
Tanner Medical Center, Inc Past Accepting new patients
TMC Children'S Healthcare of West Georgia Past Accepting new patients

Locations

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

109 Professional Pl
Carrollton, GA 30117
Phone (770) 834-0170

706 Dixie St
Ste 200
Carrollton, GA 30117
Phone (770) 214-2121

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1023301660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8710",
            "fax_number": "770-838-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PROFESSIONAL PL",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173862",
            "telephone_number": "770-834-0170",
            "fax_number": "770-214-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSS",
        "first_name": "AMY",
        "middle_name": "REED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "074196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.