Individual provider Active NPI

Brenda Goodwin, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Chattanooga, TN
National Provider Identifier
1033183462
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
30786 Issued in TN
Practice address
5616 Brainerd Rd Ste 208
Chattanooga, TN 37411-5376
Phone
(423) 265-3561
Fax
(423) 265-1364
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 30786 TN Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 178594 AK

Addresses

Primary practice location

5616 Brainerd Rd Ste 208
Chattanooga, TN 37411-5376

Mailing address

PO Box 763
Signal Mountain, TN 37377-0763
Phone (423) 290-8978

Other practice location 1

325 Market St
Chattanooga, TN 37402-1226
Phone (423) 778-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071017000245 TN Practitioner - EndocrinologyPractitioner - Internal Medicine 9537255278 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
022622LAMDPharmacist
30786TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Jun 5, 2013 Accepting new patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients
Galen Medical Group, PC PastSince Dec 1, 1993 Accepting new patients
Ut Physicians Inc Past Accepting new patients

Locations

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1033183462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 763",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373770763",
            "telephone_number": "423-290-8978",
            "fax_number": "423-760-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 BRAINERD RD STE 208",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374115376",
            "telephone_number": "423-265-3561",
            "fax_number": "423-265-1364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Market St",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374021226",
            "country_code": "US",
            "telephone_number": "423-778-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "BRENDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "30786",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AK",
            "license": "178594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.