Individual provider Active NPI

Susan R Goble, FNP

  • Nurse Practitioner
  • Englewood, TN
National Provider Identifier
1811212962
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14943 Issued in TN
Practice address
3360 Highway 411 N
Englewood, TN 37329-5276
Phone
(423) 887-5131
Fax
(423) 887-5917
NPI assigned
Apr 1, 2010
Last updated
Aug 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14943 TN Primary

Addresses

Primary practice location

3360 Highway 411 N
Englewood, TN 37329-5276

Mailing address

1923 Sulphur Springs Rd
Morristown, TN 37813-5654
Phone (423) 317-9344

Other identifiers 1

IdentifierTypeStateIssuer
1522908MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223000314 TN Practitioner - Nurse Practitioner 1759562879 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Health SystemsGroup PAC ID 3577474295, 128 clinicians

Practice addresses (Care Compare)

3360 Hwy 411 N
Englewood, TN 37329-3269
Phone (423) 887-5131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14943TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems CurrentSince Aug 6, 2021 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Jan 7, 2013 Accepting new patients
Athens Physicians Practice LLC CurrentSince Aug 4, 2014 Accepting new patients
Athens Physicians Practice, LLC CurrentSince Aug 4, 2014 Accepting new patients
Cherokee Health Systems CurrentSince Aug 6, 2021 Accepting new patients
Covenant Medical Group, Inc CurrentSince Jan 7, 2013 Accepting new patients
Cherokee Health Systems Past Accepting new patients
Athens Physicians Practice LLC Past Accepting new patients

Locations

711 Cook Dr
Ste 100
Athens, TN 37303
Phone (423) 744-7585

719 Cook Dr
Ste 104
Athens, TN 37303
Phone (423) 745-9770

3360 Highway 411 N
Englewood, TN 37329
Phone (423) 887-5131

872 Highway 411 N
Unit G
Etowah, TN 37331
Phone (423) 744-7585

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

1923 Sulphur Springs Rd
Morristown, TN 37813

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Interoperability endpoints

  • Direct secure messaging: susan.goble.p1@direct.cherokeehealth.nextgenshare.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1811212962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 HIGHWAY 411 N",
            "city": "ENGLEWOOD",
            "state": "TN",
            "postal_code": "373295276",
            "telephone_number": "423-887-5131",
            "fax_number": "423-887-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBLE",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "14943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522908",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, TN

Sources for this page

Verify at the official NPI Registry.