Individual provider Active NPI

Gina Greer Goodgame, RD

  • Registered Dietitian
  • Pearland, TX
National Provider Identifier
1184124398
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT85180 Issued in TX
Practice address
2017 Broadway St
Pearland, TX 77581-5501
Phone
(281) 485-9990
Fax
(281) 485-9469
NPI assigned
Feb 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT85180 TX Primary

Addresses

Primary practice location

2017 Broadway St
Pearland, TX 77581-5501

Mailing address

414 N Shadowbend Ave
Friendswood, TX 77546-3839

Other identifiers 2

IdentifierTypeStateIssuer
DT85180OtherTXTEXAS STATE BOARD OF EXAMINERS OF DIETITIANS
01052685OtherCOMMISSION OF DIETETIC REGISTRATION

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

LicenseStateTypeSpecialty
DT85180TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1184124398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N SHADOWBEND AVE",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 BROADWAY ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815501",
            "telephone_number": "281-485-9990",
            "fax_number": "281-485-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODGAME",
        "first_name": "GINA",
        "middle_name": "GREER",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT85180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF EXAMINERS OF DIETITIANS",
            "identifier": "DT85180",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION OF DIETETIC REGISTRATION",
            "identifier": "01052685",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.