Active NPI
Cynthia Goudeau, RD,LD
- Renal Nutrition Registered Dietitian
- Atlanta, GA
National Provider Identifier
1487873352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- LD002849
- Practice address
- 1830 Niskey Cove Rd SW
Atlanta, GA 30331-6339 - Phone
- (678) 313-4620
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | LD002849 | GA | Primary |
Addresses
Primary practice location
1830 Niskey Cove Rd SW
Atlanta, GA 30331-6339
Mailing address
1830 Niskey Cove Rd SW
Atlanta, GA 30331-6339
Phone (678) 313-4620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD002849 | GA | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487873352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 NISKEY COVE RD SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303316339",
"telephone_number": "678-313-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 NISKEY COVE RD SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303316339",
"telephone_number": "678-313-4620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUDEAU",
"first_name": "CYNTHIA",
"name_prefix": "Mrs.",
"credential": "RD,LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "GA",
"license": "LD002849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.