Amy Kay Goodman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

006889 Issued in GA

Practice address

111 Marble Mill Rd NW
Marietta, GA 30060-1047

Phone

(770) 422-1013

Fax

(770) 514-5996

NPI assigned

Aug 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Aqua Dermatology of Georgia PC

  dba Goodman Dermatology, Skin Cancer Specialists PC & Aesthetics Center

  • Dermatology Physician
  • Marietta, GA
  • NPI 1114022167
  Medicare reassignment Care Compare group
• Dermatopathology Lab of Skin Cancer Specialists, P.C.

  • Clinical Medical Laboratory
  • Marietta, GA
  • NPI 1083044465
  NPD

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1265865414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2383 Pate St N",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300783250",
            "country_code": "US",
            "telephone_number": "770-972-4845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Collier Rd NW",
            "address_2": "Suite 635",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091613",
            "country_code": "US",
            "telephone_number": "678-725-2523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "AMY",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Elaine Goodchild, ATC
• Joanne P. Goode, NP
• Malika B. Gooden, DC, MPH, CMT
• Chasity Goodin-Anderson
• James S Goodlet Jr., M.D.
• Michelle Goodman, MS,CCC
• Jacqueline Goodrich, MD
• Terri Walter Goodrich, CRNFA
• Goodscript, Inc. (Good Script Pharmacy)
• Mary Catherine Goodwin, M.D.

• Physician Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.