Chana Nicole Goodin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001474A Issued in IN

Practice address

2500 N Detroit St
Lagrange, IN 46761-1158

Phone

(260) 463-2133

Fax

(260) 463-3775

NPI assigned

Dec 6, 2012

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chana Nicole Hunter Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northeast Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Lagrange, IN
  • NPI 1174518500
  Medicare reassignment
• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment
• Parkview Health System,Inc.

  dba Parkview Physicians Group

  • Gastroenterology Physician
  • Fort Wayne, IN
  • NPI 1437461449

  Physician Assistant

  NPD
• Northeast Internal Medicine Associates, PC

  • Primary Care Nurse Practitioner
  • Lagrange, IN
  • NPI 1366859779
  NPD (past)

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1932444692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467610236",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467611158",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11104 Parkview Circle Dr Ste 330",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451674",
            "country_code": "US",
            "telephone_number": "260-494-3484",
            "fax_number": "260-969-0188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7836 W Jefferson Blvd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044165",
            "country_code": "US",
            "telephone_number": "260-494-3484",
            "fax_number": "260-969-0188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "CHANA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001474A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHANA",
            "last_name": "HUNTER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gilbert Chiropractic LLC
• Caleb Gilbert, DC
• Carlee Gilbert, DPT
• Marjorie Phoenix Gillespie, NP
• Mary Celestine Laspinas Goiti, PT
• Katie A Grabe, MSED
• Maria Grabner, NP
• Emily Guiff, NP
• Brett J. Guinn, MD
• Sana Habib, MD

• Physician Assistant in Lagrange, IN
• Providers in Lagrange, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.