NPIMap

Individual provider Active NPI

David A. Goodman, M.D.

  • Orthopaedic Surgery Physician
  • Fayetteville, GA
National Provider Identifier
1467449165
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
040080 Issued in GA
Practice address
1336 Highway 54 W
Building 500
Fayetteville, GA 30214-4549
Phone
(770) 461-1238
Fax
(770) 460-6610
NPI assigned
Sep 29, 2005
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 040080 GA Primary

Addresses

Primary practice location

1336 Highway 54 W
Building 500
Fayetteville, GA 30214-4549

Mailing address

1336 Highway 54 W
Building 500
Fayetteville, GA 30214-4549
Phone (770) 461-1238

Other identifiers 2

IdentifierTypeStateIssuer
000662208CMedicaidGA
000662208EMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721001271 GA Practitioner - Orthopedic Surgery 1254232168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Chicago College of Medicine and Surgery, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Laboratory Fitness LLCGroup PAC ID 1052858628, 45 clinicians

Practice addresses (Care Compare)

1336 Hwy 54 W
Fayetteville, GA 30214-4535
Phone (770) 461-1238

1669 Phoenix Pkwy
Suite 102
College Park, GA 30349-5462
Phone (770) 907-1023

3200 Shakerag HL
Suite C
Peachtree City, GA 30269-6524
Phone (770) 487-0760

401 Dividend Dr
Suite K
Peachtree City, GA 30269-1939
Phone (678) 506-1236

Hospital & facility affiliations

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
Hip replacement29
Knee replacement86
Lower limb (leg) arthroscopy (minimally invasive joint repair)19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040080GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Jan 1, 2000 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Jan 1, 2000 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Mar 1, 2022 Accepting new patients
Resurgens, LLC Orthopaedic Surgery Past Accepting new patients

Locations

1336 Highway 54 W
Fayetteville, GA 30214
Phone (404) 590-6890

1336 Highway 54 W
Bldg 400
Fayetteville, GA 30214
Phone (678) 251-0200

1336 Highway 54 W
Bldg 500
Fayetteville, GA 30214
Phone (770) 461-1238

665 S 8th St
Griffin, GA 30224
Phone (770) 227-7050

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: david.goodman.1@15749.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1467449165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W",
            "address_2": "BUILDING 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-461-1238",
            "fax_number": "770-460-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W",
            "address_2": "BUILDING 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-461-1238",
            "fax_number": "770-460-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "040080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000662208C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000662208E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.