Individual provider Active NPI

Patricia Nicole Goodin, R.N.

  • Registered Nurse
  • Clinton, TN
National Provider Identifier
1902387996
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
229796 Issued in TN
Practice address
1107 N Charles G Seivers Blvd Ste 101
Clinton, TN 37716-3944
Phone
(865) 934-6150
Fax
(865) 342-0150
NPI assigned
Aug 27, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 229796 TN Primary

Addresses

Primary practice location

1107 N Charles G Seivers Blvd Ste 101
Clinton, TN 37716-3944

Mailing address

1923 Sulphur Springs Rd
Morristown, TN 37813-5654
Phone (423) 317-9344

Other names 1

  • Patricia Nicole Liles Former name

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
229796TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems Past Accepting new patients

Organizations & group practices 1

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1902387996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N CHARLES G SEIVERS BLVD STE 101",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377163944",
            "telephone_number": "865-934-6150",
            "fax_number": "865-342-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "PATRICIA",
        "middle_name": "NICOLE",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "229796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "LILES",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.