Tina L Goodson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

LL1778 Issued in NV

Practice address

2810 W Charleston Blvd
Suite 78
Las Vegas, NV 89102-1921

Phone

(702) 968-5084

NPI assigned

Jul 3, 2007

Sex

Female

Sole proprietor

Yes

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 AR, NV2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stark Medicine McKay Khurana Jeider PLLCGroup PAC ID 1557601978, 23 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Stark Medicine McKay Khurana Jeider PLLC

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1053880856
  Medicare reassignment Care Compare group
• University of Arkansas

  • Multi-Specialty Clinic/Center
  • Fayetteville, AR
  • NPI 1619908787
  Medicare reassignment NPD

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467650358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GRAVEL HILL ST",
            "address_2": "UNIT 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891176970",
            "telephone_number": "702-538-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W CHARLESTON BLVD",
            "address_2": "SUITE 78",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021921",
            "telephone_number": "702-968-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "TINA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "LL1778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Goodsell
• Allena Goodson
• Cedraya Goodson
• Donald Goodson
• Mycheal Goodson
• Maangelica Goodstein, P.T, DPT, PA-C
• Goodwill Health Care LLC
• Goodwill Home Health LLC
• Goodwill Pharmacy Inc.
• Goodwill Ventures Inc

• Psychiatry Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.