NPIMap

Individual provider Active NPI

Susan J Gouge, DO

  • Family Medicine Physician
  • Ooltewah, TN
National Provider Identifier
1972537512
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO0000001721 Issued in TN
Practice address
9309 Apison Pike
Ooltewah, TN 37363-4340
Phone
(423) 551-3562
Fax
(423) 551-3563
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO0000001721 TN Primary

Addresses

Primary practice location

9309 Apison Pike
Ooltewah, TN 37363-4340

Mailing address

PO Box 25403
Chattanooga, TN 37422-5403
Phone (423) 618-9018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029002449 GA Practitioner - Family Practice 9234139601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

60 Erlanger S Dr
Ringgold, GA 30736-3179
Phone (706) 937-9292

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1721NCMDClinical Psychologist
DO0000001721TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health Family Medicine CurrentSince Jun 10, 2024 Accepting new patients
Erlanger Health CurrentSince Jun 10, 2024 Accepting new patients

Locations

1329 W Walnut Ave
Ste 1
Dalton, GA 30720
Phone (423) 778-9901

60 Erlanger South Dr
Ringgold, GA 30736
Phone (706) 937-9292

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
GentivaChattanooga, TN, CCN 441576 Hospice Contracted Managing Employee Nov 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1972537512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25403",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374225403",
            "telephone_number": "423-618-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9309 APISON PIKE",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634340",
            "telephone_number": "423-551-3562",
            "fax_number": "423-551-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGE",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO0000001721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.