Individual provider Active NPI

Robert Patten Goolsby, MD

  • Obstetrics & Gynecology Physician
  • Birmingham, AL
National Provider Identifier
1720054224
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
17106 Issued in AL
Practice address
2700 10TH Ave S
Suite 306
Birmingham, AL 35205-1200
Phone
(205) 933-4020
Fax
(205) 933-4022
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 17106 AL Primary

Addresses

Primary practice location

2700 10TH Ave S
Suite 306
Birmingham, AL 35205-1200

Mailing address

2700 10TH Ave S
Suite 306
Birmingham, AL 35205-1200
Phone (205) 933-4020

Other identifiers 1

IdentifierTypeStateIssuer
009914745MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000641 AL Practitioner - Obstetrics/Gynecology 6709043839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17106ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp & Stone OB/GYN, P.C. Obstetrics & Gynecology CurrentSince Mar 1, 2003 Accepting new patients
St. Vincent'S Birmingham Past Accepting new patients

Locations

2700 10th Ave S
Ste 306
Birmingham, AL 35205
Phone (205) 933-4020

Organizations & group practices 2

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1720054224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 10TH AVE S",
            "address_2": "SUITE 306",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051200",
            "telephone_number": "205-933-4020",
            "fax_number": "205-933-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 10TH AVE S",
            "address_2": "SUITE 306",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051200",
            "telephone_number": "205-933-4020",
            "fax_number": "205-933-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "ROBERT",
        "middle_name": "PATTEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "17106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009914745",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.