Ketty M Gonzalez, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

026280 Issued in GA

Practice address

1916 N Leg Rd
Augusta, GA 30909-4402

Phone

(706) 667-4265

Fax

(706) 667-4301

NPI assigned

Apr 25, 2007

Last updated

Nov 3, 2015By the provider in NPPES

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1427277672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 N LEG RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094402",
            "telephone_number": "706-667-4265",
            "fax_number": "706-667-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 N LEG RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094402",
            "telephone_number": "706-667-4265",
            "fax_number": "706-667-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KETTY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "GA",
            "license": "026280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Morton Goldman, DDS. MS.
• Barry Jay Goldsmith, M.D.
• Ashley Goley, RBT
• Colby Ann Gonzales
• Joyce Noel Gonzales, M.D.
• John Lewis Good, DDS
• Michael Goodall
• Tiiu Tomika Goode
• Kristin Heller Goodell, DDS
• Memory Kate Goodin, OTR/L

• Public Health & General Preventive Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Public Health & General Preventive Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.