Goran Djordje Antic, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34506 Issued in TN

Practice address

1265 E College St
Pulaski, TN 38478-4541

Phone

(931) 363-7531

Fax

(865) 291-3228

NPI assigned

May 25, 2006

Last updated

Nov 6, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1124074752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636019",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E COLLEGE ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784541",
            "telephone_number": "931-363-7531",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIC",
        "first_name": "GORAN",
        "middle_name": "DJORDJE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "34506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amg-Hillside LLC (Essentials Wellness Center)
• Amg-Hillside LLC (Urology Associates of South Central TN)
• Amg-Hillside, LLC (Ardmore Behavioral Health Clinic)
• Amg-Hillside, LLC (Southern Tennessee Surgical Services-Pulaski)
• Angelic Caregivers
• Austin Hewitt House, LLC (Hewitt House Assisted Living)
• Lorraine C Bailey, DC
• Zach Brewer Bailey
• Eresvita Balatico, M.D.
• Ferdinand A. Balatico, M.D.

• Emergency Medicine Physician in Pulaski, TN
• Providers in Pulaski, 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 Nov 6, 2007; 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.