Clarence E Goulding III, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

15893 Issued in TN

Practice address

200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278

Phone

(423) 915-5033

Fax

(423) 952-3777

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1033292362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MED TECH PKWY",
            "address_2": "SUITE 108",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042278",
            "telephone_number": "423-915-5033",
            "fax_number": "423-952-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MED TECH PKWY",
            "address_2": "SUITE 108",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042278",
            "telephone_number": "423-915-5033",
            "fax_number": "423-952-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDING",
        "first_name": "CLARENCE",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "15893",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "15893",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3017571",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul William Gorman, M.D.
• James A Goss, M.D.
• Gretel L Gossett, M.S. CF-SLP
• Kyle Dane Gotfried, MD
• Edie B Gouge, PHARMD
• Sagar Goyal, MD
• Grace Internal Medicine, LLC
• Grace Services, LLC (Grace Health Services)
• Matthew Grace, AGNP-C
• Anthony Grady

• Emergency Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.