Individual provider Active NPI

Michele Elaine Goodchild, ATC

  • Athletic Trainer
  • Marietta, GA
National Provider Identifier
1184265217
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT003077 Issued in GA
Practice address
1590 Bill Murdock Rd
Marietta, GA 30062-5999
Phone
(770) 578-3225
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X AT003077 GA Primary

Addresses

Primary practice location

1590 Bill Murdock Rd
Marietta, GA 30062-5999

Mailing address

1590 Bill Murdock Rd
Marietta, GA 30062-5999
Phone (770) 578-3225

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
AT003077GAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1184265217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 BILL MURDOCK RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625999",
            "telephone_number": "770-578-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 BILL MURDOCK RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625999",
            "telephone_number": "770-578-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODCHILD",
        "first_name": "MICHELE",
        "middle_name": "ELAINE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.