MEDICARE: GOODMAN HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner
2	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1447119383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOODMAN HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	10730 HUNTER LAKE LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8986
Country	:	US
Telephone Number	:	317-531-1783
Fax Number	:	317-854-9277

Provider Business Practice Location Address
First Line	:	3500 DEPAUW BLVD STE 10801
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1170
Country	:	US
Telephone Number	:	317-531-1783
Fax Number	:	317-854-9277

Authorized Official
Title or Position	:	OWNER & CEO
Name	:	TIFFANY MARIE GOODMAN
Credential	:
Telephone Number	:	317-531-1783

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “GOODMAN HEALTH SERVICES LLC ” Practice Location

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