Individual provider Active NPI

Sophia D Goodridge, M.D.

  • Urology Physician
  • Roswell, GA
National Provider Identifier
1255690905
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
82831 Issued in GA
Practice address
2500 Hospital Blvd Ste 290
Roswell, GA 30076
Phone
(470) 956-4230
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 52077 KY
Urology Physician 208800000X 82831 GA Primary

Addresses

Primary practice location

2500 Hospital Blvd Ste 290
Roswell, GA 30076

Mailing address

2500 Hospital Blvd Ste 290
Roswell, GA 30076-4918
Phone (470) 956-4230

Other practice location 1

20 York Street T-209
Yale New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 688-2259

Other practice location 2

60 Bryan Blvd
Corbin, KY 40701-2779
Phone (606) 528-1172

Other identifiers 1

IdentifierTypeStateIssuer
7100580160MedicaidKY

Other names 1

  • Sophia Delpe Former name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190211000592 KY Practitioner - Urology 6709166440 Reassigns benefits to 2 organizations
I20190719000894 GA Practitioner - Urology 6709166440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of North Carolina at Chapel Hill School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2450 Old Milton Pkwy
Alpharetta, GA 30009-2521

2500 Hospital Blvd
Suite 290
Roswell, GA 30076-4918
Phone (770) 410-4388

2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570

2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274

2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

55 Whitcher Nest
Marietta, GA 30060-1169
Phone (770) 428-4475

55 Whitcher St
Suite 260
Marietta, GA 30060-1169
Phone (943) 202-7050

601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721

Hospital & facility affiliations

  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jun 25, 2019 Accepting new patients
T J Samson Community Hospital CurrentSince Aug 2, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 25, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 25, 2019 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

2450 Old Milton Pkwy
Ste 204
Alpharetta, GA 30009
Phone (470) 267-0190

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2500 Hospital Blvd
Ste 290
Roswell, GA 30076
Phone (770) 410-4670

60 Bryan Blvd
Corbin, KY 40701
Phone (606) 523-3021

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

Interoperability endpoints

  • Direct secure messaging: sgoodridge343600@directwellstar.org

Organizations & group practices 5

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 5

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": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1255690905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 290",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764918",
            "telephone_number": "470-956-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 290",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "470-956-4230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York Street T-209",
            "address_2": "Yale New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-2259",
            "fax_number": "203-688-5599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Bryan Blvd",
            "address_purpose": "LOCATION",
            "city": "Corbin",
            "state": "KY",
            "postal_code": "407012779",
            "country_code": "US",
            "telephone_number": "606-528-1172",
            "fax_number": "606-528-7169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODRIDGE",
        "first_name": "SOPHIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "52077",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "82831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100580160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIA",
            "last_name": "DELPE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.