Individual provider Active NPI

Djalika Sanogo-Goines, APN-FC

  • Primary Care Nurse Practitioner
  • Willingboro, NJ
National Provider Identifier
1730718578
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ01024600 Issued in NJ
Practice address
87 Toledo LN
Willingboro, NJ 08046-3744
Phone
(215) 586-0950
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26NJ01024600 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ01024600 NJ Primary
Family Medicine Physician 207Q00000X SP022025 PA

Addresses

Primary practice location

87 Toledo LN
Willingboro, NJ 08046-3744

Mailing address

87 Toledo LN
Willingboro, NJ 08046-3744
Phone (215) 586-0950

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
26NJ01024600NJMDFamily Medicine Physician
SP022025PAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1730718578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 TOLEDO LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463744",
            "telephone_number": "215-586-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 TOLEDO LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463744",
            "telephone_number": "215-586-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANOGO-GOINES",
        "first_name": "DJALIKA",
        "name_prefix": "Mrs.",
        "credential": "APN-FC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ01024600",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01024600",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP022025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.