GOODE PROVIDER NPI 1225527989

NPI Information

  • NPI: 1225527989
  • Provider Name: GOODE PROVIDER
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Organization
  • CLIA Number: 44D2300930
  • Address: 2969 MOUNTAIN TERRACE ST
    MEMPHIS, TN
    ZIP 38127
  • Phone: (901) 821-1123

Map and Directions

Get Directions

NPI Details

GOODE PROVIDER is an adult health nurse practitioner in Memphis, TN. GOODE PROVIDER NPI is 1225527989. The provider is registered as an organization entity type.

The provider's business location address is:

2969 MOUNTAIN TERRACE ST
MEMPHIS, TN
ZIP 38127-335
Phone: (901) 821-1123

The provider's authorized official is Brenda Montgomery .
The authorized official title is Administrator and has the following contact phone number (346) 262-2669.

The CLIA number assigned to this NPI record is 44D2300930 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/8/2018 and was last updated on 2/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive CareNo
2363LA2200XNurse PractitionerAdult HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI