Gwenda Faye Goggin, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110840426 Issued in VA

Practice address

830 S Gloster St
Tupelo, MS 38801-4934

Phone

(662) 377-6608

NPI assigned

May 25, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• North Ms Emergency Physicians

  • Emergency Medicine Physician
  • Tupelo, MS
  • NPI 1891724035
  NPD (past)
• Abercrombie Radiological Consultants Inc

  • Diagnostic Radiology Physician
  • Knoxville, TN
  • NPI 1942207154
  NPD (past)
• Dispatchhealth-Idaho PC

  dba DispatchHealth

  • Emergency Medicine Physician
  • Knoxville, TN
  • NPI 1043825219
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811943780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 WATER OAK CT",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388666899",
            "telephone_number": "662-844-9095",
            "fax_number": "662-844-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-6608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Glen Forest Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232263768",
            "country_code": "US",
            "telephone_number": "804-495-0053",
            "fax_number": "720-598-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOGGIN",
        "first_name": "GWENDA",
        "middle_name": "FAYE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840426",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110840426",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MS",
            "license": "PA078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy Coleman Glenn, PHARMD
• Jacob Gloer
• Gloster North Family Medical Clinic Inc
• Stephanie Glover, MSN AGNP-C
• Alisha Goff, OTR
• Dylan Goin
• Shawonna Lynn Goins
• Erica W Golden
• Melanie Golding, R.PH.
• Amanda Gonzalez

• Physician Assistant in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.