JOHN GOODFRED DO NPI 1891842696

NPI Information

NPI: 1891842696
Provider Name: JOHN GOODFRED, DO
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3965 S MENDENHALL RD STE 6
MEMPHIS, TN
ZIP 38115
Phone: (901) 365-1800
Get Directions

John Goodfred, DO is a general practice in Memphis, TN. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee John Goodfred, DO NPI is 1891842696. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3965 S MENDENHALL RD STE 6
MEMPHIS, TN
ZIP 38115-914
Phone: (901) 365-1800
Fax: (901) 365-1862

The NPI 1891842696 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/4/2007 and was last updated on 3/25/2009.

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
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	208D00000X	General Practice		1807	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3001738	MEDICARE UPIN	TENNESSEE
2	3370244	MEDICARE PIN	TENNESSEE

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: 4/28/2024

NPI Synchronization or Removal

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