Individual provider Active NPI

Susane L Gooding, MD

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Pennington, NJ
National Provider Identifier
1902028897
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
25MA07633100 Issued in NJ
Practice address
2480 Pennington Rd
Suite 108
Pennington, NJ 08534-5227
Phone
(609) 737-6700
Fax
(609) 737-2427
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA07633100 NJ
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 25MA07633100 NJ Primary

Addresses

Primary practice location

2480 Pennington Rd
Suite 108
Pennington, NJ 08534-5227

Mailing address

PO Box 8500-9117
Philadelphia, PA 19178-9117
Phone (609) 815-7810

Other identifiers 1

IdentifierTypeStateIssuer
0015091MedicaidNJ

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

State licenses

LicenseStateTypeSpecialty
MA07633100NJMDInternal Medicine Physician
25MA07633100NJMDPreventive Medicine/Occupational Environmental Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1902028897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-9117",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789117",
            "telephone_number": "609-815-7810",
            "fax_number": "609-815-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 PENNINGTON RD",
            "address_2": "SUITE 108",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085345227",
            "telephone_number": "609-737-6700",
            "fax_number": "609-737-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODING",
        "first_name": "SUSANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA07633100",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NJ",
            "license": "25MA07633100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015091",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.