Active NPI
Michael D Goodlett, MD
- Sports Medicine (Family Medicine) Physician
- Auburn, AL
National Provider Identifier
1154399863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 10954
- Practice address
- 349 South Donahue Drive
Suite 200
Auburn, AL 36849 - Phone
- (334) 844-9821
- Fax
- (334) 844-0932
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 10954 | AL | Primary |
Addresses
Primary practice location
349 South Donahue Drive
Suite 200
Auburn, AL 36849
Mailing address
349 South Donahue Drive
Suite 200
Auburn, AL 36849
Phone (334) 844-9821
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51521101 | Other | AL | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10954 | AL | MD | Sports Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1154399863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "349 SOUTH DONAHUE DRIVE",
"address_2": "SUITE 200",
"city": "AUBURN",
"state": "AL",
"postal_code": "36849",
"telephone_number": "334-844-9821",
"fax_number": "334-844-0932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 SOUTH DONAHUE DRIVE",
"address_2": "SUITE 200",
"city": "AUBURN",
"state": "AL",
"postal_code": "36849",
"telephone_number": "334-844-9821",
"fax_number": "334-844-0932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODLETT",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "AL",
"license": "10954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "51521101",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.