Active NPI
Anna B Goodmon, M.D.
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1891912705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2007-00662
- Practice address
- 1921 Falls Valley Dr
Raleigh, NC 27615-3446 - Phone
- (919) 872-0250
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 2007-00662 | NC | Primary |
Addresses
Primary practice location
1921 Falls Valley Dr
Raleigh, NC 27615-3446
Mailing address
1921 Falls Valley Dr
Raleigh, NC 27615-3446
Phone (919) 872-0250
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1891912705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 FALLS VALLEY DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153446",
"telephone_number": "919-872-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 FALLS VALLEY DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153446",
"telephone_number": "919-872-0250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMON",
"first_name": "ANNA",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2007-00662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.