Active NPI
Susane L Gooding, MD
- Preventive Medicine/Occupational Environmental Medicine Physician
- Pennington, NJ
National Provider Identifier
1902028897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 25MA07633100
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015091 | Medicaid | NJ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA07633100 | NJ | MD | Internal Medicine Physician |
| 25MA07633100 | NJ | MD | Preventive 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.