John William Goolsby III

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

600 N Jefferson St # C
Dublin, GA 31021-6302

Phone

(478) 292-5755

Fax

(877) 374-5772

NPI assigned

Jun 28, 2021

Last updated

Jun 28, 2021By the provider in NPPES

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tri Star Drug and Alcohol

  • Clinic/Center
  • Dublin, GA
  • NPI 1285341503
  NPD Authorized official

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1780254243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N JEFFERSON ST # C",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310216302",
            "telephone_number": "478-292-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JEFFERSON ST # C",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310216302",
            "telephone_number": "478-292-5755",
            "fax_number": "877-374-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.tristardrugandalchol.com",
            "affiliation": "N",
            "endpointDescription": "Tri Star Drug & Alchol",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "600 N Jefferson St # C",
            "city": "Dublin",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310216302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "customerservice@tristartesting.com",
            "affiliation": "N",
            "endpointDescription": "Tri Star Drug & Alchol",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "600 N Jefferson St # C",
            "city": "Dublin",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310216302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nichele Colette Gillis, RN
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• Lorena Alicia Giron
• Calandra L Glanton, PHARM.D.
• Tyrone Gonder, LPC
• Brenda Lee Gordy
• David Howard Gorney, CRNA
• GPS Behavioral Health LLC
• Grace Family Care LLC
• Baserine C. Grace, LPN

• Case Manager/Care Coordinator in Dublin, GA
• Providers in Dublin, GA by specialty
• Case Manager/Care Coordinator in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.