Jonathan M Goodin, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

58474 Issued in GA

Practice address

804 Dixie St
Carrollton, GA 30117-4416

Phone

(770) 834-0606

Fax

(770) 834-1833

NPI assigned

Apr 26, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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 and National Provider Directory roles.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787

  Pediatrics

  Medicare reassignment NPD
• TMC Children'S Healthcare of West Georgia

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1518972348
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1679530596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-834-0606",
            "fax_number": "770-834-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174416",
            "telephone_number": "770-834-0606",
            "fax_number": "770-834-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "58474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000084170",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Goad, OD
• John E Godard, M.D.
• Mary L Godard
• Sheena Rene Gonzalez, CPNP-PC
• Goodbodys Minor Med Express Care
• Gwyndolyn B. Goodwin, D.C.
• Gordon T. Austin, D.M.D., P.C.
• Jefferson Taylor Gordon, M.D.
• Jenny Lyle Gordon
• Olivia Katelyn Gordon, MS, RD, LD

• Pediatrics Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.