Active NPI
Kenneth Goewey
- Prosthetics Case Management
- Rome, GA
National Provider Identifier
1972562775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 000989
- Practice address
- 2400 Garden Lakes Blvd NW
Suite D
Rome, GA 30165-1100 - Phone
- (706) 232-6600
- Fax
- (706) 232-6677
- NPI assigned
- Mar 21, 2006
- 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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 000989 | GA | Primary |
Addresses
Primary practice location
2400 Garden Lakes Blvd NW
Suite D
Rome, GA 30165-1100
Mailing address
2400 Garden Lakes Blvd NW
Suite D
Rome, GA 30165-1100
Phone (706) 232-6600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1022740 | Other | GA | ACM PROVIDER |
| 52071299001 | Other | GA | BLUE CROSS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000989 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pansy'S Post Mastectomy Boutique, Inc. | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Rome, GA
- NPI 1194904540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1972562775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 GARDEN LAKES BLVD NW",
"address_2": "SUITE D",
"city": "ROME",
"state": "GA",
"postal_code": "301651100",
"telephone_number": "706-232-6600",
"fax_number": "706-232-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 GARDEN LAKES BLVD NW",
"address_2": "SUITE D",
"city": "ROME",
"state": "GA",
"postal_code": "301651100",
"telephone_number": "706-232-6600",
"fax_number": "706-232-6677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEWEY",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "GA",
"license": "000989",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACM PROVIDER",
"identifier": "1022740",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "52071299001",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.