Thomas E Goodrich MD SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28720 Issued in WI

Legal business name

THOMAS E GOODRICH MD SC

Practice address

6015 Durand Ave
Suite 500
Mount Pleasant, WI 53406-5089

Phone

(262) 456-1000

Fax

(262) 456-1654

NPI assigned

Feb 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Edward Goodrich, M.D.

Title

President

Phone

(262) 456-1000

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1679712400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 DURAND AVE",
            "address_2": "SUITE 500",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065089",
            "telephone_number": "262-456-1000",
            "fax_number": "262-456-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 DURAND AVE",
            "address_2": "SUITE 500",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065089",
            "telephone_number": "262-456-1000",
            "fax_number": "262-456-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS E GOODRICH MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "GOODRICH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-456-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "28720",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "28720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30830700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.