Active NPI
David A Goldberg, PT
- Physical Therapist
- Greenville, SC
National Provider Identifier
1659457356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1367
- Practice address
- 200 Patewood Dr
Ste C150
Greenville, SC 29615-3593 - Phone
- (864) 454-0904
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 1367 | SC | Primary |
Addresses
Primary practice location
200 Patewood Dr
Ste C150
Greenville, SC 29615-3593
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-2312101 | Other | SC | BLUE CHOICE |
| 20-2312101 | Other | SC | PREMIER |
| 20-2312101 | Other | SC | UHC |
| P00228285 | Other | SC | MEDICARE RAILROAD |
| 20-2312101 | Other | SC | CAROLINA CARE PLAN |
| 9799717 | Other | SC | CIGNA |
| DD4407 | Other | SC | MEDICARE RAILROAD GRP |
| E2939 | Other | SC | MEDCOST |
| TH0916 | Medicaid | SC | |
| 20-2312101 | Other | FOCUS | |
| 20-2312101 | Other | SC | GREATWEST |
| 20-2312101 | Other | SC | BCBS OF SOUTH CAROLINA |
| 20-2312101 | Other | SC | KANAWHA |
| 20-2312101 | Other | SC | TRICARE |
| 607756100 | Other | SC | DEPT OF LABOR |
| 7761758 | Other | SC | AETNA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1367 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446768000000",
"number": "1659457356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR",
"address_2": "STE C150",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153593",
"telephone_number": "864-454-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "DAVID",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2015-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "1367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMIER",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00228285",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAROLINA CARE PLAN",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9799717",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD GRP",
"identifier": "DD4407",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "E2939",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH0916",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FOCUS",
"identifier": "20-2312101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF SOUTH CAROLINA",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANAWHA",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "20-2312101",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "607756100",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7761758",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.