Individual provider Active NPI

Ellis L Goodin, M.D.

  • Diagnostic Radiology Physician
  • Nashville, TN
National Provider Identifier
1790762219
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9637 Issued in TN
Practice address
210 25TH Ave N Ste 1204
Nashville, TN 37203-1620
Phone
(615) 312-0600
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9637 TN Primary

Addresses

Primary practice location

210 25TH Ave N Ste 1204
Nashville, TN 37203-1620

Mailing address

210 25TH Ave N Ste 1204
Nashville, TN 37203-1620
Phone (615) 312-0600

Other practice location 1

103 Physicians Way Ste 100
Lebanon, TN 37090-4129
Phone (615) 443-7436

Other practice location 2

4488 Carothers Pkwy Ste 110
Franklin, TN 37067-6584
Phone (615) 721-0935

Other identifiers 4

IdentifierTypeStateIssuer
3036027MedicaidTN
3791068MedicaidTN
64771223MedicaidKY
3791307MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041029000626 TN Practitioner - Diagnostic Radiology 9537121884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians

Practice addresses (Care Compare)

210 25TH Ave N
Suite 1204
Nashville, TN 37203-1620
Phone (615) 312-0600

660 S Mount Juliet Rd
Suite 110
Mount Juliet, TN 37122-3968
Phone (615) 514-6460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Oncology PLLC Diagnostic Radiology CurrentSince Aug 24, 2020 Accepting new patients
Lebanon Pet Scan Center, LLC Diagnostic Radiology CurrentSince Aug 24, 2020 Accepting new patients
Tennessee Oncology, PLLC Diagnostic Radiology CurrentSince Aug 24, 2020 Accepting new patients
Tennessee Oncology,PLLC Diagnostic Radiology Past Accepting new patients
Smith County Memorial Hospital LLC Past Accepting new patients
Radcare of Tennessee PC Diagnostic Radiology Past Accepting new patients
Sumner Radiology, PC Diagnostic Radiology PastSince Jul 1, 2011 Accepting new patients
Radiology Alliance CT Diagnostic Radiology Past Accepting new patients

Locations

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

605 Glenwood Dr
Ste 200
Chattanooga, TN 37404
Phone (423) 698-1844

776 Weatherly Dr
Clarksville, TN 37043
Phone (931) 906-2004

4488 Carothers Pkwy
Ste 110
Franklin, TN 37067
Phone (615) 320-7387

103 Physicians Way
Ste 100
Lebanon, TN 37090
Phone (615) 443-7436

2018 Murphy Ave
Ste 200
Nashville, TN 37203
Phone (615) 320-7387

4220 Harding Pike
Ste 101
Nashville, TN 37205
Phone (615) 354-1255

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

3441 Dickerson Pike
Nashville, TN 37207
Phone (615) 234-6426

210 25th Ave N
Ste 602
Nashville, TN 37203
Phone (615) 312-0604

322 22nd Ave N
Ste 140
Nashville, TN 37203
Phone (615) 320-5090

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1790762219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 25TH AVE N STE 1204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031620",
            "telephone_number": "615-312-0600",
            "fax_number": "615-320-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 25TH AVE N STE 1204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031620",
            "telephone_number": "615-312-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Physicians Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "TN",
            "postal_code": "370904129",
            "country_code": "US",
            "telephone_number": "615-443-7436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4488 Carothers Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370676584",
            "country_code": "US",
            "telephone_number": "615-721-0935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "ELLIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "9637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3036027",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3791068",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64771223",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3791307",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.