Individual provider Active NPI

Michael Clay Good, M.D.

  • Obstetrics & Gynecology Physician
  • Crossville, TN
National Provider Identifier
1760430862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD20246 Issued in TN
Practice address
100 Lantana Rd Ste 202
Crossville, TN 38555-1903
Phone
(931) 484-5141
Fax
(931) 484-5620
NPI assigned
May 4, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD20246 TN Primary

Addresses

Primary practice location

100 Lantana Rd Ste 202
Crossville, TN 38555-1903

Mailing address

100 Lantana Rd Ste 202
Crossville, TN 38555-1903
Phone (931) 484-5141

Other practice location 1

112 Airport Business Park Dr Ste A
Shelbyville, TN 37160-7453
Phone (931) 492-4705

Other practice location 2

Roane Professional Building
8035 Roane Medical Center Drive
harriman, TN 37748
Phone (931) 484-5141

Other practice location 3

112 Airport Business Park Dr Ste A
Shelbyville, TN 37160-7453
Phone (931) 492-4705

Other identifiers 2

IdentifierTypeStateIssuer
Q007338MedicaidTN
3079968MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address good.michael@covenanthealth.cernerdirect.com

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
MD20246TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael C Good MD PLLC Obstetrics & Gynecology CurrentSince Mar 18, 2009 Accepting new patients
Vanderbilt University Medical Center Obstetrics & Gynecology Past Accepting new patients
Rene C del Valle MD PLLC Obstetrics & Gynecology Past Accepting new patients

Locations

1321 McArthur St
Ste B
Manchester, TN 37355
Phone (931) 723-2265

Interoperability endpoints

  • Direct secure messaging: good.michael@covenanthealth.cernerdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760430862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LANTANA RD STE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-484-5141",
            "fax_number": "931-484-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LANTANA RD STE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-484-5141",
            "fax_number": "931-484-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Airport Business Park Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "TN",
            "postal_code": "371607453",
            "country_code": "US",
            "telephone_number": "931-492-4705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Roane Professional Building",
            "address_2": "8035 Roane Medical Center Drive",
            "address_purpose": "LOCATION",
            "city": "harriman",
            "state": "TN",
            "postal_code": "37748",
            "country_code": "US",
            "telephone_number": "931-484-5141",
            "fax_number": "865-374-2074",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 Airport Business Park Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "TN",
            "postal_code": "371607453",
            "country_code": "US",
            "telephone_number": "931-492-4705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOOD",
        "first_name": "MICHAEL",
        "middle_name": "CLAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "MD20246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007338",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3079968",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "good.michael@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Lantana Rd Ste 202",
            "city": "Crossville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385551903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.