Individual provider Active NPI

Deborah Jean Gould, MD

  • Geriatric Psychiatry Physician
  • Beachwood, OH
National Provider Identifier
1679631949
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
35036148 Issued in OH
Practice address
23210 Chagrin Blvd
Suite 400
Beachwood, OH 44122-5429
Phone
(216) 831-6466
Fax
(216) 766-6083
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 35036148 OH Primary

Addresses

Primary practice location

23210 Chagrin Blvd
Suite 400
Beachwood, OH 44122-5429

Mailing address

23210 Chagrin Blvd
Suite 400
Beachwood, OH 44122-5429
Phone (216) 831-6466

Other identifiers 2

IdentifierTypeStateIssuer
000000345557OtherBLUE CROSS SHIELD
880908MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
35036148OHMDGeriatric Psychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679631949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23210 CHAGRIN BLVD",
            "address_2": "SUITE 400",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225429",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23210 CHAGRIN BLVD",
            "address_2": "SUITE 400",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225429",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "OH",
            "license": "35036148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SHIELD",
            "identifier": "000000345557",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880908",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.