Shannon Page Goossen, AP, LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP 1566 Issued in FL

Practice address

14546 Old St Augustine Road
Suite 403
Jacksonville, FL 32258

Phone

(904) 296-1500

Fax

(904) 391-1005

NPI assigned

Mar 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1902048598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-296-1500",
            "fax_number": "904-391-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14546 OLD ST AUGUSTINE ROAD",
            "address_2": "SUITE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32258",
            "telephone_number": "904-296-1500",
            "fax_number": "904-391-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOSSEN",
        "first_name": "SHANNON",
        "middle_name": "PAGE",
        "name_prefix": "Ms.",
        "credential": "AP, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP 1566",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 20767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Prince Goold, MD
• Ruphlal Robert Gooljar
• Kevin Goolsby, M.A., LMHC, NCC
• Shannon Richards Goolsby
• Goolsbys Clinical Services, LLC
• Gopal Pharmacy LLC
• Neethu Gopal, MBBS
• Rajesh Gopal, M.D.
• Vikram Devegowda Gopal, MD
• Arun Gopinath, M.D

• Acupuncturist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.