Mackenzie Tilston Goode-Roberts, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

006453 Issued in KY

Practice address

982 Eastern Pkwy
Louisville, KY 40217-1566

Phone

(502) 635-6397

NPI assigned

Mar 10, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mackenzie Roberts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1023817335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 MONTFORT LN",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400149172",
            "telephone_number": "502-888-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 EASTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171566",
            "telephone_number": "502-635-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE-ROBERTS",
        "first_name": "MACKENZIE",
        "middle_name": "TILSTON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "KY",
            "license": "006453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "ROBERTS",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Good Shepherd Healthcare Solutions, Inc.
• Michael Paul Good, PT, ATC
• Holly Goodaker
• Joshua Goodan, CRNA
• Tami Goodbub
• Alexandria Marie Goode, BSW, RBT
• Kaitlyn Leanne Goode, DMD
• Tyrus D Goode, LPCA #281717
• Vanessa Goode, APRN
• Jennifer L. Goodell, PTA

• Pediatric Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.