NPI
Jacob Avery Gomoke
NPI 1477744373
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- PT
- Type
- Individual
- Enumeration date
- 2007-08-06
- Last updated
- 2007-08-06
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Specialties
Licenses
- License VA
- 2305202181
Location
- Practice location
- 5818 Harbour View Blvd # D, Suite 150
- City
- Suffolk VA
- Postal code
- 23435-3315
- Phone
- (757) 638-1800
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Suffolk, VA. 2,273 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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