NPIMap

Individual provider Active NPI

Gainneos R. Goldie, MD

  • Internal Medicine Physician
  • Snellville, GA
National Provider Identifier
1194778878
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
87599 Issued in GA
Practice address
3020 Highway 124
Snellville, GA 30039-4614
Phone
(770) 978-1331
Fax
(770) 978-8580
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M0735 TX
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 87599 GA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD447980 PA
Internal Medicine Physician 207R00000X 87599 GA Primary

Addresses

Primary practice location

3020 Highway 124
Snellville, GA 30039-4614

Mailing address

3020 Highway 124
Snellville, GA 30039-4614
Phone (770) 978-1331

Other identifiers 4

IdentifierTypeStateIssuer
8W8852OtherTXBLUE CROSS BLUE SHIELD
175370901MedicaidTX
175370903MedicaidTX
175370902MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130514000417 PA Practitioner - Geriatric Medicine 3779515754 Reassigns benefits to 1 organization
I20210305000359 GA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 3779515754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. B Abraham PCGroup PAC ID 4981693314, 7 clinicians

Practice addresses (Care Compare)

3020 Hwy 124
Snellville, GA 30039-4614
Phone (770) 978-1331

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Tucker, GA, CCN 117026
  • Aveanna Home Health Home health agency, Duluth, GA, CCN 117336
  • Accentcare Home Health of Northeast Georgia Home health agency, Buford, GA, CCN 117139
  • Amedisys Home Health of Covington Home health agency, Covington, GA, CCN 117065
  • Centerwell Home Health Home health agency, Kennesaw, GA, CCN 117027
  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD447980PAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
Lehigh Valley Physician Group Internal Medicine CurrentSince Jan 8, 2019 Accepting new patients
Dr. B Abraham PC CurrentSince Mar 25, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 8, 2019 Accepting new patients
Dallas County Hospital District Past Accepting new patients
Vickery Health Center Past Accepting new patients

Locations

3020 Scenic Hwy S
Snellville, GA 30039
Phone (770) 978-1331

2100 Mack Blvd
Fl 4
Allentown, PA 18103

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 7

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1194778878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HIGHWAY 124",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394614",
            "telephone_number": "770-978-1331",
            "fax_number": "770-978-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HIGHWAY 124",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394614",
            "telephone_number": "770-978-1331",
            "fax_number": "770-978-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDIE",
        "first_name": "GAINNEOS",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M0735",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "87599",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD447980",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "87599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8W8852",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175370901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175370903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175370902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.