Active NPI
Fidel S Goldson Jr., D.C., P.T.
- Chiropractor
- Pembroke Pines, FL
National Provider Identifier
1558378745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH9276
- Practice address
- 10796 Pines Blvd.
#105
Pembroke Pines, FL 33026-2129 - Phone
- (954) 367-4888
- Fax
- (954) 367-4889
- NPI assigned
- Aug 1, 2006
- Last updated
- Feb 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH9276 | FL | Primary |
| Physical Therapist | 225100000X | PT19489 | FL |
Addresses
Primary practice location
10796 Pines Blvd.
#105
Pembroke Pines, FL 33026-2129
Mailing address
10796 Pines Blvd.
#105
Pembroke Pines, FL 33026-2129
Phone (954) 367-4888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 380230200 | Medicaid | FL |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fidel S. Goldson, DC PA | Past | Accepting new patients | |
| Dr. Rhea Conley, LLC | Chiropractor | Past | Accepting new patients |
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.
-
dba Goldson Spine Rehab Center
- Rehabilitation Clinic/Center
- Plantation, FL
- NPI 1023480985
-
- Chiropractor
- Pembroke Pines, FL
- NPI 1679940548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1558378745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10796 PINES BLVD.",
"address_2": "#105",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330262129",
"telephone_number": "954-367-4888",
"fax_number": "954-367-4889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10796 PINES BLVD.",
"address_2": "#105",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330262129",
"telephone_number": "954-367-4888",
"fax_number": "954-367-4889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSON",
"first_name": "FIDEL",
"middle_name": "S",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C., P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH9276",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT19489",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "380230200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.