Individual provider Active NPI

Thomas M Goodman, M.D.

  • Family Medicine Physician
  • Montgomery, AL
National Provider Identifier
1609874882
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AL14383 Issued in AL
Practice address
300 Twining St BLDG 760
Montgomery, AL 36112-6027
Phone
(334) 953-5143
Fax
(334) 953-8607
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AL14383 AL Primary

Addresses

Primary practice location

300 Twining St BLDG 760
Montgomery, AL 36112-6027

Mailing address

300 Twining St BLDG 760
Montgomery, AL 36112-6027
Phone (334) 953-5143

Other identifiers 1

IdentifierTypeStateIssuer
51517723OtherALBLUE CROSS AND BLUE SHIEL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20150105001154 AL Order and Referring Only - Family PracticePractitioner - Family Practice 4789573791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AL14383ALMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1609874882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TWINING ST BLDG 760",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5143",
            "fax_number": "334-953-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TWINING ST BLDG 760",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5143",
            "fax_number": "334-953-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "AL14383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "51517723",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.