Active NPI
Susan K. Goode, NP
- Nurse Practitioner
- Daleville, VA
National Provider Identifier
1063485985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0024-000048
- Practice address
- 46 Wesley Rd
Daleville, VA 24083-3082 - Phone
- (540) 992-4100
- NPI assigned
- Feb 10, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024-000048 | VA | Primary |
Addresses
Primary practice location
46 Wesley Rd
Daleville, VA 24083-3082
Mailing address
101 Elm Ave SE
Roanoke, VA 24013
Phone (540) 224-5170
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7788037 | Medicaid | VA |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024-000048 | VA | MD | Nurse Practitioner |
Interoperability endpoints
- susan.goode.1@14940.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294876800000",
"number": "1063485985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 ELM AVE SE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "24013",
"telephone_number": "540-224-5170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 WESLEY RD",
"city": "DALEVILLE",
"state": "VA",
"postal_code": "240833082",
"telephone_number": "540-992-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODE",
"first_name": "SUSAN",
"middle_name": "K.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-10",
"last_updated": "2011-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024-000048",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7788037",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Daleville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.