DR. SUSAN J GOUGE DO
NPI 1972537512
Family Medicine in Ooltewah, TN

Q: What is Susan Gouge's NPI number?

The NPI number for Susan Gouge is 1972537512. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Q: What is Susan Gouge's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Gouge was last updated on October 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment

87.73/100

CMS Quality Rating

9309 APISON PIKE, OOLTEWAH, TN 37363(423) 551-3562(423) 551-3563 Get Directions Write a Review

NPPES record last updated: October 31, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 31, 2023, Apr 6, 2023, Mar 8, 2022 and 1 more (4 updates tracked since 2019).

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About Dr. Susan J Gouge Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN J GOUGE DO (NPI 1972537512) is an individual family medicine provider in Ooltewah, Tennessee, licensed in Tennessee (DO0000001721) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Starr Regional Medical Center Athens, and is a graduate of West Virginia School Of Osteopathic Medicine (2003).

NPPES Registry Identity

NPI1972537512

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SUSAN J GOUGECredential: DO

Location Address9309 APISON PIKEOoltewah, TN 37363-4340

Mailing AddressPo Box 25403Chattanooga, TN 37422-5403 · (423) 618-9018

Phone(423) 551-3562

Fax(423) 551-3563

Sole ProprietorYes

Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2003

Enumeration DateJuly 10, 2006

Last NPPES UpdateOctober 31, 20234 updates tracked since enumeration

NPPES CertifiedOctober 31, 2023

✔ NPI 1972537512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TN · DO0000001721

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

9309 APISON PIKE, Ooltewah, TN 37363

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Susan J Gouge Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234139601

PECOS Enrollment IDI20241029002449

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

76 services50 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

25 services25 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

24 services19 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

23 services22 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

17 services15 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

17 services17 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Starr Regional Medical Center Athens

Acute Care Hospitals · Athens, TN

4/5 CMS rating

OwnershipProprietary

CMS Certification Number440068

Location1114 W Madison AveAthens, TN 37371 · Mc Minn County

Emergency services Birthing friendly

Memorial Healthcare System, Inc

Acute Care Hospitals · Chattanooga, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number440091

Location2525 Desales AveChattanooga, TN 37404 · Hamilton County

Erlanger Medical Center

Acute Care Hospitals · Chattanooga, TN

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440104

Location975 E 3rd StChattanooga, TN 37403 · Hamilton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37363 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.67

Promoting Interoperability

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers15 claims54 services$6.32 avg. paid by Medicare

Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038

DME-Other DME · category DE000N

1 supplier11 claims11 services$10.37 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$51.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. OLIVER MARKO BUJAK MD

Family Medicine