Active NPI
Philip Richard Good, RD, LD
- Registered Dietitian
- Forest Park, GA
National Provider Identifier
1740427947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D01786
- Practice address
- 5015 N 34TH St
BLDG 900
Forest Park, GA 30297-5245 - Phone
- (404) 469-4034
- NPI assigned
- Jan 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D01786 | MD | Primary |
Addresses
Primary practice location
5015 N 34TH St
BLDG 900
Forest Park, GA 30297-5245
Mailing address
6638 Bear Swamp Rd
Medina, OH 44256-9765
Phone (301) 775-8233
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
| License | State | Type | Specialty |
|---|---|---|---|
| D01786 | MD | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231545600000",
"number": "1740427947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6638 BEAR SWAMP RD",
"city": "MEDINA",
"state": "OH",
"postal_code": "442569765",
"telephone_number": "301-775-8233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5015 N 34TH ST",
"address_2": "BLDG 900",
"city": "FOREST PARK",
"state": "GA",
"postal_code": "302975245",
"telephone_number": "404-469-4034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOD",
"first_name": "PHILIP",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-10",
"last_updated": "2009-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "D01786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.