Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1346235470 Deactivated / Inactive NPI Male Practitioner

Dr. Mohan Hire Goudar , MD

Specialist • Norfolk, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mohan Goudar has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 14, 2005
NPI Deactivation Date February 11, 2019
Total Practice Duration ~14 Years of Practice (2005 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Mohan Goudar, MD was a registered Specialist practicing in Norfolk, VA. Throughout an active medical career spanning 14 years, Dr. Goudar provided care at the practice location at 110 KINGSLEY LN until profile deactivation on 2019-02-11.

Practice Location & Contact Primary Location

Practice Address

110 Kingsley Ln
Suite 209

Norfolk, VA 235054614

Telephone 7574893911
Fax 7578893913
Associated Practice Facility / Clinic
🏢 Goudar Corporation Facility NPI 1861593717

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Norfolk, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 40.3 Yrs
State Avg: 37.5 Yrs
Regional Practice Density
52 Specialists

Practicing in Norfolk, VA (878 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License VA 0101030509

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Kevin Halista , MD

Radiology - Diagnostic Radiology

NPI 1013976075

Doctor of Medicine (M.D.)

Dr. Antoine Arrage , MD

Internal Medicine

NPI 1013997733

Doctor of Medicine (M.D.)

Laura Riddle , AGACNP-BC

Nurse Practitioner - Acute Care

NPI 1023423340

Adult-Gerontology Acute Care Nurse Practitioner (Board Certified)

Dr. Annamalai Muthiah , MD

Radiology - Diagnostic Radiology

NPI 1063407997

Doctor of Medicine (M.D.)

Marlene Lorenz , NP

Nurse Practitioner

NPI 1063487452

Nurse Practitioner

Ebony Canady , LCSW

Social Worker - Clinical

NPI 1093173528

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated February 11, 2019

Record deactivated on February 11, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 110 KINGSLEY LN, SUITE 209, NORFOLK, VA 235054614 (Tel: 7574893911)

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Updated Business Mailing Address July 08, 2007

Registered at 110 KINGSLEY LN, SUITE 209, NORFOLK, VA 235054614 (Tel: 7574893911)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MOHAN GOUDAR, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #0101030509 in VA)

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Initial NPI Registration & Enumeration September 14, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346235470
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 14, 2005
Last Update: July 08, 2007
Deactivation Date: February 11, 2019

Mailing Address

110 Kingsley Ln, Suite 209

Norfolk, VA 235054614

Phone: 7574893911

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.