Active NPI
Elizabeth Grey Goodman, PT, DPT
- Physical Therapist
- Camden, NC
National Provider Identifier
1639737372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05013341A
- Practice address
- 111A Sunset Ave
Camden, NC 27921-9641 - Phone
- (252) 312-9719
- NPI assigned
- May 29, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05013341A | IN | Primary |
Addresses
Primary practice location
111A Sunset Ave
Camden, NC 27921-9641
Mailing address
111A Sunset Ave
Camden, NC 27921-9641
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 |
|---|---|---|---|
| 05013341A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1639737372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111A SUNSET AVE",
"city": "CAMDEN",
"state": "NC",
"postal_code": "279219641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111A SUNSET AVE",
"city": "CAMDEN",
"state": "NC",
"postal_code": "279219641",
"telephone_number": "252-312-9719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "ELIZABETH",
"middle_name": "GREY",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05013341A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camden, NC
- Creative Counseling Service, LLC
- Creative Counseling Services, LLC
- Michelle Elaine Creech, M.S. CCC-SLP
- Morgan Gallop
- Katherine Donovan Godfrey, RN
- Martha Mitchell Goodman, LPC
- Shirley Nicole Harden, DNP
- Healing Hearts Idd Support Services LLC
- Healthcare Partners Consulting and Billing, LLC
- Martin Hood
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.