JOHN CONRAD GOUSE M.D. NPI 1154315083

NPI Information

NPI: 1154315083
Provider Name: JOHN CONRAD GOUSE, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
7505 WATERS AVE
SUITE C8
SAVANNAH, GA
ZIP 31406
Phone: (912) 352-2606
Get Directions

John Conrad Gouse, M.D. is a diagnostic radiology radiology in Savannah, GA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. John Conrad Gouse, M.D. NPI is 1154315083. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7505 WATERS AVE
SUITE C8
SAVANNAH, GA
ZIP 31406-825
Phone: (912) 352-2606
Fax: (912) 352-0623

The NPI 1154315083 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2005 and was last updated on 6/21/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	028558	GEORGIA	No
2	2085N0904X	Radiology	Nuclear Radiology	028558	GEORGIA	No
3	2085P0229X	Radiology	Pediatric Radiology	028558	GEORGIA	No
4	2085U0001X	Radiology	Diagnostic Ultrasound	028558	GEORGIA	No
5	2085R0202X	Radiology	Diagnostic Radiology	028558	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30016960	OTHER	GEORGIA	KEYSTONE MERCY
2	023574	OTHER	GEORGIA	BLUE CROSS
3	300043683	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	MEDICARE RR
4	30CDBHZ	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	MEDICARE
5	G28558	MEDICAID	SOUTH CAROLINA
6	F24863	MEDICARE UPIN	GEORGIA
7	00330536A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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