Active NPI
David Randall Goetz, M.D.
- Orthopaedic Surgery Physician
- Greenville, SC
National Provider Identifier
1669420253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 10201
- Practice address
- 105 Doctors Dr
Greenville, SC 29605-5608 - Phone
- (864) 797-7060
- Fax
- (864) 797-7077
- NPI assigned
- May 5, 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 10201 | SC | Primary |
Addresses
Primary practice location
105 Doctors Dr
Greenville, SC 29605-5608
Mailing address
1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102016 | Medicaid | SC | |
| P00817224 | Other | SC | RR MEDICARE |
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1669420253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT",
"address_2": "SUITE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154545",
"telephone_number": "864-797-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 DOCTORS DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296055608",
"telephone_number": "864-797-7060",
"fax_number": "864-797-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETZ",
"first_name": "DAVID",
"middle_name": "RANDALL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "SC",
"license": "10201",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102016",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00817224",
"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 Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.