Active NPI
Samuel Goldeen
- Chiropractor
- San Diego, CA
National Provider Identifier
1649945205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 36115
- Practice address
- 6747 Thomson CT
San Diego, CA 92111-5935 - Phone
- (619) 241-1326
- NPI assigned
- Aug 14, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 36115 | CA | Primary |
Addresses
Primary practice location
6747 Thomson CT
San Diego, CA 92111-5935
Mailing address
6747 Thomson CT
San Diego, CA 92111-5935
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87-1295099 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | info@inhomechiro.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1649945205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6747 THOMSON CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921115935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6747 THOMSON CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921115935",
"telephone_number": "619-241-1326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDEEN",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-14",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "CA",
"license": "36115",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "87-1295099",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "info@inhomechiro.com",
"affiliation": "N",
"address_1": "6747 Thomson Ct",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921115935",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.