Jeffrey E Goldberg, MD, PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036754 Issued in GA

Legal business name

JEFFREY E GOLDBERG, MD, PC

Practice address

4245 Johns Creek Parkway
Suite D
Suwanee, GA 30024

Phone

(770) 495-3820

Fax

(770) 495-3820

NPI assigned

Jan 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey E Goldberg, MD

Title

Owner

Phone

(770) 495-3820

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Children's ENT Associates Doing business as

Locations

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1114103595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PARKWAY",
            "address_2": "SUITE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "770-495-3820",
            "fax_number": "770-495-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PARKWAY",
            "address_2": "SUITE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "770-495-3820",
            "fax_number": "770-495-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY E GOLDBERG, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-495-3820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "036754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000630594B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's ENT Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Specialty Clinic/Center in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Medical Specialty Clinic/Center in Georgia

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

Verify at the official NPI Registry.