NPIMap

Organization Active NPI

Neil E Goodman MD PC

  • Pediatric Adolescent Medicine Physician
  • Brunswick, GA
National Provider Identifier
1104831064
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
034143 Issued in GA
Legal business name
NEIL E GOODMAN MD PC
Practice address
2500 Starling St
Suite # 401
Brunswick, GA 31520-4219
Phone
(912) 554-0544
Fax
(912) 554-0344
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Neil Evan Goodman, M.D.NPI 1538448402
Title
President / Owner
Phone
(912) 554-0544

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 034143 GA
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X 034143 GA Primary

Addresses

Primary practice location

2500 Starling St
Suite # 401
Brunswick, GA 31520-4219

Mailing address

2500 Starling St
Suite # 401
Brunswick, GA 31520-4219
Phone (912) 554-0544

Other identifiers 2

IdentifierTypeStateIssuer
00714876GMedicaidGA
034143OtherGASTATE MED LIC NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1104831064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST",
            "address_2": "SUITE # 401",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204219",
            "telephone_number": "912-554-0544",
            "fax_number": "912-554-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST",
            "address_2": "SUITE # 401",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204219",
            "telephone_number": "912-554-0544",
            "fax_number": "912-554-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL E GOODMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "912-554-0544",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "034143",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "034143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00714876G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MED LIC NUMBER",
            "identifier": "034143",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.