Kenneth E. Goolsby, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

025162 Issued in GA

Practice address

200 S Enota Dr NE
Gainesville, GA 30501-3473

Phone

(770) 534-8832

Fax

(770) 531-7479

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Medical College of Georgia School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kenneth E. Goolsby, MD and Associates, PCGroup PAC ID 8123016151, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBEHCD
• FHIR API: https://fhir4.healow.com/fhir/r4/IBEHCD/Endpoint/IBEHCD

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.

• Kenneth E. Goolsby, MD & Associates, PC

  • Psychiatry Physician
  • Gainesville, GA
  • NPI 1215942875
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366457012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE",
            "address_2": "SUITE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013473",
            "telephone_number": "770-534-8832",
            "fax_number": "770-531-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013473",
            "telephone_number": "770-534-8832",
            "fax_number": "770-531-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "KENNETH",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "025162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00358586C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.