Active NPI
Paul A Goodlett, MD
- Family Medicine Physician
- Shelbyville, KY
National Provider Identifier
1770575979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36027
- Practice address
- 101 Stonecrest Road
Suite 3
Shelbyville, KY 40065 - Phone
- (502) 633-5565
- Fax
- (502) 633-5154
- NPI assigned
- Aug 16, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36027 | KY | Primary |
Addresses
Primary practice location
101 Stonecrest Road
Suite 3
Shelbyville, KY 40065
Mailing address
101 Stonecrest Road
Suite 3
Shelbyville, KY 40065
Phone (502) 633-5565
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000197979 | Other | ANTHEM | |
| 64029614 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Louisville School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- PT Pros, Inc
Practice addresses (Care Compare)
101 Stonecrest Rd
Suite 3
Shelbyville, KY 40065-8169
Phone (502) 633-5565
4031 N Dixie Hwy
Suite 104
Elizabethtown, KY 42701-7873
Phone (270) 982-4776
Hospital & facility affiliations
- Caretenders
- Uofl Health - Shelbyville Hospital
- Baptist Health Louisville
- UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital
- Norton Hospitals, Inc
- Baptist Health Lagrange
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36027 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stonecrest Family Medicine PLLC | Current | Accepting new patients | |
| Deaconess Hospital Inc | Past | Accepting new patients |
Locations
101 Stonecrest Rd
Ste 3
Shelbyville, KY 40065
Phone (502) 633-5565
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Shelbyville, KY
- NPI 1659322808
-
- Mental Health Counselor
- Evansville, IN
- NPI 1508723552
Hospital & facility affiliations 40
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1265539498
-
- General Acute Care Hospital
- La Grange, KY
- NPI 1306925540
-
- Home Health Agency
- Louisville, KY
- NPI 1770767410
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1043348808
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1447388335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770575979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 STONECREST ROAD",
"address_2": "SUITE 3",
"city": "SHELBYVILLE",
"state": "KY",
"postal_code": "40065",
"telephone_number": "502-633-5565",
"fax_number": "502-633-5154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 STONECREST ROAD",
"address_2": "SUITE 3",
"city": "SHELBYVILLE",
"state": "KY",
"postal_code": "40065",
"telephone_number": "502-633-5565",
"fax_number": "502-633-5154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODLETT",
"first_name": "PAUL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "36027",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000197979",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64029614",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.