NPIMap

Individual provider Active NPI

James S Goodlet Jr., M.D.

  • Urology Physician
  • Marietta, GA
National Provider Identifier
1225033442
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
17808 Issued in GA
Practice address
185 Blair Valley Dr NE
Marietta, GA 30060-8033
Phone
(770) 880-5372
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 11080 ND
Urology Physician 208800000X 11769 ME
Urology Physician 208800000X 17808 GA Primary
Urology Physician 208800000X 11769 MT
Urology Physician 208800000X 23959 AL

Addresses

Primary practice location

185 Blair Valley Dr NE
Marietta, GA 30060-8033

Mailing address

185 Blair Valley Dr NE
Marietta, GA 30060-8033
Phone (770) 880-5372

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23959ALMDUrology Physician
11769MEMDUrology Physician
11769MTMDUrology Physician
11080NDMDUrology Physician
11080AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Clinic of South Alabama, LLC PastSince Oct 1, 2007 Accepting new patients
Urology Clinic, LLC Past Accepting new patients
Urology Enterprises, PC Urology PastSince May 1, 2013 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1225033442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 BLAIR VALLEY DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608033",
            "telephone_number": "770-880-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 BLAIR VALLEY DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608033",
            "telephone_number": "770-880-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLET",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ND",
            "license": "11080",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "11769",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "17808",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "11769",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AL",
            "license": "23959",
            "primary": false
        }
    ],
    "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 10, 2010; 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.