Individual provider Active NPI

Luke Austin Gooden

  • Pharmacist
  • Elizabethtown, NC
National Provider Identifier
1710437843
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24303 Issued in NC
Practice address
1347 W Broad St
Elizabethtown, NC 28337-9548
Phone
(910) 241-6158
Fax
(910) 241-6157
NPI assigned
Oct 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24303 NC Primary

Addresses

Primary practice location

1347 W Broad St
Elizabethtown, NC 28337-9548

Mailing address

1347 W Broad St
Elizabethtown, NC 28337-9548
Phone (910) 862-8517

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

State licenses

LicenseStateTypeSpecialty
24303NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP PastSince Oct 13, 2024 Accepting new patients
Wal-Mart Stores East LP Past Accepting new patients
Wal-Mart Stores East LP PastSince Oct 13, 2024 Accepting new patients

Organizations & group practices 3

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": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1710437843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1347 W BROAD ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283379548",
            "telephone_number": "910-862-8517",
            "fax_number": "910-862-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1347 W BROAD ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283379548",
            "telephone_number": "910-241-6158",
            "fax_number": "910-241-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODEN",
        "first_name": "LUKE",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "24303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.