Individual provider Active NPI

Bradley Eugene Goff, M.D.

  • Otolaryngology Physician
  • Calhoun, GA
National Provider Identifier
1487725263
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
43944 Issued in GA
Practice address
110 Hospital Dr
Calhoun, GA 30701-2079
Phone
(706) 602-3104
Fax
(706) 602-3105
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 43944 GA Primary

Addresses

Primary practice location

110 Hospital Dr
Calhoun, GA 30701-2079

Mailing address

PO Box 12938
C/O Clinic Management
Calhoun, GA 30703-7013

Other identifiers 2

IdentifierTypeStateIssuer
000837185GMedicaidGA
000837185HMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43944GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Georgia E.N.T. Inc. PastSince Feb 17, 2000 Accepting new patients

Organizations & group practices 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1487725263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "C/O CLINIC MANAGEMENT",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307037013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL DR",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307012079",
            "telephone_number": "706-602-3104",
            "fax_number": "706-602-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "BRADLEY",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "43944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000837185G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000837185H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.