Active NPI
John O Goodin, MD
- Ophthalmology Physician
- Tacoma, WA
National Provider Identifier
1710919790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 21743
- Practice address
- 3602 S 19TH Street
Tacoma, WA 98405 - Phone
- (253) 759-5555
- Fax
- (253) 830-5420
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 21743 | WA | Primary |
Addresses
Primary practice location
3602 S 19TH Street
Tacoma, WA 98405
Mailing address
3602 S 19TH Street
Tacoma, WA 98405
Phone (253) 759-5555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1070234 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21743 | WA | MD | Ophthalmology Physician |
Interoperability endpoints
- john.goodin@832.chartlogic.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326326400000",
"number": "1710919790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3602 S 19TH STREET",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "253-759-5555",
"fax_number": "253-830-5420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3602 S 19TH STREET",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "253-759-5555",
"fax_number": "253-830-5420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODIN",
"first_name": "JOHN",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2012-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WA",
"license": "21743",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1070234",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.