Goodlife Cardiac Care, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GOODLIFE CARDIAC CARE, LLC

Practice address

2400 Herodian Way SE Ste 220
Smyrna, GA 30080-8500

Phone

(770) 383-1415

NPI assigned

Dec 2, 2022

Organization subpart

No

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

Authorized official

Name

Laqueta Nelson, NPNPI 1982247433

Title

Owner/Provider

Phone

(770) 383-1415

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laqueta Nelson, FNP

  • Family Medicine Physician
  • Cumming, GA
  • NPI 1982247433
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1104536853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HERODIAN WAY SE STE 220",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808500",
            "telephone_number": "770-383-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HERODIAN WAY SE STE 220",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808500",
            "telephone_number": "770-383-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODLIFE CARDIAC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "LAQUETA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "770-383-1415",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@goodlifecardiaccare.com",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2400 Herodian Way SE Ste 220",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300808500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellyn Laura Goldstein, LCSW
• Martin I Goldstein, M.D.
• Daniel P Golightly Jr., MD
• Jami Michele Gomarko, D.C.
• Seleztino Gonzalez
• Heather Ann Gore, LAT, ATC
• Gaelle Laure Essenam Gounteni, PMHNP-BC
• Sandeep Kumar Govil, M.D.
• Grace Senior Living Home Care
• Iyonna Grady

• Nurse Practitioner in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.

Verify at the official NPI Registry.