Individual provider Active NPI

Skylar Goodman Poland, AUD

  • Audiologist
  • Suffolk, VA
National Provider Identifier
1548885874
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001774 Issued in VA
Practice address
1030 Champions Way
Suffolk, VA 23435-3914
Phone
(757) 673-6118
NPI assigned
Jun 12, 2020
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001774 VA Primary

Addresses

Primary practice location

1030 Champions Way
Suffolk, VA 23435-3914

Mailing address

1030 Champions Way
Suffolk, VA 23435-3914
Phone (757) 673-6118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201111000690 VA Practitioner - Qualified Audiologist 4183034788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1030 Champions Way
Suffolk, VA 23435-3914
Phone (757) 673-6118

13195 Warwick Blvd
2C
Newport News, VA 23602-8313
Phone (804) 877-4221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201001774VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 13, 2022 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 13, 2022 Accepting new patients

Locations

13195 Warwick Blvd
Ste 2C
Newport News, VA 23602
Phone (804) 877-4221

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

1030 Champions Way
Suffolk, VA 23435
Phone (757) 673-6118

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1548885874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 CHAMPIONS WAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353914",
            "telephone_number": "757-673-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 CHAMPIONS WAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353914",
            "telephone_number": "757-673-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAND",
        "first_name": "SKYLAR",
        "middle_name": "GOODMAN",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.