Active NPI
Karen Davis Goodson, PTA
- Physical Therapy Assistant
- Fairhope, AL
National Provider Identifier
1114217783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1068
- Practice address
- 212 Hospital Dr
Suite B
Fairhope, AL 36532-2058 - Phone
- (251) 279-1640
- NPI assigned
- Apr 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1068 | AL | Primary |
Addresses
Primary practice location
212 Hospital Dr
Suite B
Fairhope, AL 36532-2058
Mailing address
212 Hospital Dr
Suite B
Fairhope, AL 36532-2058
Phone (251) 279-1640
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1068 | AL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infirmary Therapy Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Children's Rehabilitation Hospital
- Fairhope, AL
- NPI 1831415827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302825600000",
"number": "1114217783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 HOSPITAL DR",
"address_2": "SUITE B",
"city": "FAIRHOPE",
"state": "AL",
"postal_code": "365322058",
"telephone_number": "251-279-1640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 HOSPITAL DR",
"address_2": "SUITE B",
"city": "FAIRHOPE",
"state": "AL",
"postal_code": "365322058",
"telephone_number": "251-279-1640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSON",
"first_name": "KAREN",
"middle_name": "DAVIS",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-15",
"last_updated": "2011-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "1068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairhope, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.