Active NPI
Samuel L Goodson, BS, LMBT
- Mechanotherapist
- Clayton, NC
National Provider Identifier
1023899614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 20022
- Practice address
- 120 E Main St # 200
Clayton, NC 27520-2448 - Phone
- (919) 698-4648
- NPI assigned
- Oct 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 20022 | NC | Primary |
Addresses
Primary practice location
120 E Main St # 200
Clayton, NC 27520-2448
Mailing address
502 Ballast PT
Clayton, NC 27520-6217
Phone (919) 698-4648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20022 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1023899614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 BALLAST PT",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275206217",
"telephone_number": "919-698-4648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E MAIN ST # 200",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275202448",
"telephone_number": "919-698-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSON",
"first_name": "SAMUEL",
"middle_name": "L",
"credential": "BS, LMBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "NC",
"license": "20022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.