Individual provider Active NPI

S M Gould Mulligan, D.P.M.

  • Podiatrist
  • Cherry Hill, NJ
National Provider Identifier
1174545420
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00263000 Issued in NJ
Practice address
52 Berlin Rd
Suite 5000
Cherry Hill, NJ 08034-3574
Phone
(856) 795-1003
Fax
(856) 795-5994
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00263000 NJ Primary

Addresses

Primary practice location

52 Berlin Rd
Suite 5000
Cherry Hill, NJ 08034-3574

Mailing address

52 Berlin Rd
Suite 5000
Cherry Hill, NJ 08034-3574
Phone (856) 795-1003

Other identifiers 9

IdentifierTypeStateIssuer
01000464100OtherNJAMERICHOICE
51310OtherNJAMERIGROUP
6299205OtherGHI
8601801MedicaidNJ
2008280000OtherNJAMERIHEALTH
7382775OtherNJCIGNA
IK9329OtherHEALTH NET
1153685OtherNJHORIZON NJ HEALTH
P2524077OtherOXFORD

Other names 1

  • Sandra M Gould Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1174545420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BERLIN RD",
            "address_2": "SUITE 5000",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343574",
            "telephone_number": "856-795-1003",
            "fax_number": "856-795-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BERLIN RD",
            "address_2": "SUITE 5000",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343574",
            "telephone_number": "856-795-1003",
            "fax_number": "856-795-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD MULLIGAN",
        "first_name": "S",
        "middle_name": "M",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00263000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "01000464100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "51310",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6299205",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8601801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2008280000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7382775",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "IK9329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1153685",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2524077",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "GOULD",
            "middle_name": "M",
            "credential": "D.P.M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.