Neil E. Goodman, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

034143 Issued in GA

Practice address

5500 Frederica Rd Unit 2208
St Simons Island, GA 31522-9703

Phone

(912) 268-4633

Fax

(888) 771-6577

NPI assigned

Aug 10, 2011

Last updated

Feb 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

• Goodman Medical Services, PC

  dba Activate Health

  • Family Medicine Physician
  • Brunswick, GA
  • NPI 1093430654

  Adolescent Medicine

  NPD Authorized official
• Neil E Goodman MD PC

  • Pediatric Adolescent Medicine Physician
  • Brunswick, GA
  • NPI 1104831064

  Pediatrics

  NPD (past) Authorized official
• Centered for Life, Inc

  • Counselor
  • St Simons Island, GA
  • NPI 1922686682

  Pediatrics

  NPD (past)
• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677369600000",
    "number": "1538448402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CARRIAGE DR",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225457",
            "telephone_number": "912-230-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 FREDERICA RD UNIT 2208",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315229703",
            "telephone_number": "912-268-4633",
            "fax_number": "888-771-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "NEIL",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "034143",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "139707",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "SC",
            "license": "82230",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "269918",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "034143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "34143",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michelle Ann Good, OTR/L
• Meghan Goutremout, PT
• Shirley R Grant
• Nyasia Gray, PHARMD
• Christopher Green
• Eva Haile, LCSW

• Pediatric Adolescent Medicine Physician in St Simons Island, GA
• Providers in St Simons Island, 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 Feb 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.