Active NPI
Gooden Mobile Pod NC PLLC
- Podiatrist
- Fayetteville, NC
National Provider Identifier
1073003752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- GOODEN MOBILE POD NC PLLC
- Practice address
- 311 McFadyen Dr
Fayetteville, NC 28314 - Phone
- (502) 244-2441
- Fax
- (502) 254-4069
- NPI assigned
- May 17, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tamika Gooden
- Title
- Owner
- Phone
- (502) 244-2441
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
311 McFadyen Dr
Fayetteville, NC 28314
Mailing address
12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone (502) 244-2441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180703003175 | NC | Part B Supplier - Clinic/Group Practice | 2769738715 |
Receives reassigned benefits from 21 practitioners Practice locations: Fayetteville, NC |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 25
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Primary Podiatric Medicine Podiatrist
- Jacksonville, NC
- NPI 1114085321
NC, Single Specialty
-
- Primary Podiatric Medicine Podiatrist
- Raleigh, NC
- NPI 1588667265
NC, Podiatrist
-
- Foot & Ankle Surgery Podiatrist
- Statesville, NC
- NPI 1174606156
NC
-
- Foot & Ankle Surgery Podiatrist
- Charlotte, NC
- NPI 1104083427
NC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1526515200000",
"number": "1073003752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12910 SHELBYVILLE RD STE 300",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402432404",
"telephone_number": "502-244-2441",
"fax_number": "502-254-4069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 MCFADYEN DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28314",
"telephone_number": "502-244-2441",
"fax_number": "502-254-4069"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOODEN MOBILE POD NC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-05-17",
"last_updated": "2018-05-17",
"status": "A",
"authorized_official_last_name": "GOODEN",
"authorized_official_first_name": "TAMIKA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "502-244-2441"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.