Susan M Goldberg, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

057465 Issued in GA

Practice address

4321 University Pkwy
Suite 104
Evans, GA 30809-3058

Phone

(706) 854-2600

Fax

(706) 854-2601

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susan K Goldberg Other name

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

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1497787139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 UNIVERSITY PKWY",
            "address_2": "SUITE 104",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093058",
            "telephone_number": "706-854-2600",
            "fax_number": "706-854-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 UNIVERSITY PKWY",
            "address_2": "SUITE 104",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093058",
            "telephone_number": "706-854-2600",
            "fax_number": "706-854-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "057465",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "057465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GOLDBERG",
            "middle_name": "K",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jocilyn Girouard, DPT
• Shauna Renay Givens
• Global Mentality
• Global Mentality Inc
• Deandre Omar Goins
• Golden Circle Comprehensive Services LLC
• Carlos Golston, CCC, SLP
• Alice Janie Goodman, PHARMD
• Henry North Goodwin Jr., MD
• Grace Pediatrics, PC

• Pediatric Adolescent Medicine Physician in Evans, GA
• Providers in Evans, GA by specialty
• Pediatric Adolescent Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.