Individual provider Active NPI

Reginald Gerald Gooden, M.AC.,L.AC.

  • Acupuncturist
  • Ellicott City, MD
National Provider Identifier
1194018887
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U01879 Issued in MD
Practice address
8388 Court Ave
Suite 202
Ellicott City, MD 21043-4514
Phone
(443) 675-8806
NPI assigned
May 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U01879 MD Primary

Addresses

Primary practice location

8388 Court Ave
Suite 202
Ellicott City, MD 21043-4514

Mailing address

5 Kew Garden Court
Baltimore, MD 21244-8086
Phone (443) 675-8806

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
U01879MDMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1194018887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KEW GARDEN COURT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212448086",
            "telephone_number": "443-675-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8388 COURT AVE",
            "address_2": "SUITE 202",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434514",
            "telephone_number": "443-675-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODEN",
        "first_name": "REGINALD",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "M.AC.,L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-27",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U01879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.