Active NPI
Charles B. Goss, D.O.
- Psychiatry Physician
- Farmington Hills, MI
National Provider Identifier
1952468779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- CG006234
- Practice address
- 28100 Grand River Ave
Suite 102
Farmington Hills, MI 48336-5967 - Phone
- (248) 471-5700
- Fax
- (248) 851-5515
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | CG006234 | MI | Primary |
Addresses
Primary practice location
28100 Grand River Ave
Suite 102
Farmington Hills, MI 48336-5967
Mailing address
28100 Grand River Ave
Suite 102
Farmington Hills, MI 48336-5967
Phone (248) 471-5700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2756329434 | Other | MI | BLUE CROSS & BLUE SHIELD |
| 1091313 11 00 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG006234 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201219200000",
"number": "1952468779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28100 GRAND RIVER AVE",
"address_2": "SUITE 102",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365967",
"telephone_number": "248-471-5700",
"fax_number": "248-851-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28100 GRAND RIVER AVE",
"address_2": "SUITE 102",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365967",
"telephone_number": "248-471-5700",
"fax_number": "248-851-5515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSS",
"first_name": "CHARLES",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2008-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "CG006234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "2756329434",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1091313 11 00",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.