Individual provider Active NPI

Lauren Gooch

  • Pediatric Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1699307314
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN257834 Issued in GA
Practice address
1485 Jesse Jewell Pkwy NE Ste 200
Gainesville, GA 30501-3802
Phone
(770) 534-5255
Fax
(770) 287-3871
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN257834 GA Primary

Addresses

Primary practice location

1485 Jesse Jewell Pkwy NE Ste 200
Gainesville, GA 30501-3802

Mailing address

1485 Jesse Jewell Pkwy NE Ste 200
Gainesville, GA 30501-3802
Phone (770) 534-5255

Other practice location 1

2695 Old Winder Hwy
Braselton, GA 30517-6075
Phone (770) 534-5255

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN257834GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates LLP PastSince Feb 16, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1699307314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 JESSE JEWELL PKWY NE STE 200",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013802",
            "telephone_number": "770-534-5255",
            "fax_number": "770-287-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 JESSE JEWELL PKWY NE STE 200",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013802",
            "telephone_number": "770-534-5255",
            "fax_number": "770-287-3871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2695 Old Winder Hwy",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305176075",
            "country_code": "US",
            "telephone_number": "770-534-5255",
            "fax_number": "770-287-3871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN257834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.