Gracelyn J. Goodwin, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA17498 Issued in FL

Practice address

2711 Capital Medical Blvd
Tallahassee, FL 32308-4497

Phone

(850) 210-1172

NPI assigned

Sep 9, 2020

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

• Mrs. Grace Goodwin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1003421710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 HIGHWAY 90",
            "city": "SNEADS",
            "state": "FL",
            "postal_code": "324602232",
            "telephone_number": "850-557-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084497",
            "telephone_number": "850-210-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "GRACELYN",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "GOODWIN",
            "prefix": "MRS.",
            "credential": "COTA/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Howell Stewart Goodman Jr., PHARM. D
• Maria Goodman
• Betty Jean Goodpasture, ARNP
• Wanda Frances Goodreau, DMD
• Angela Goodson, RN, IBCLC
• Jade Goodwin
• Stacy Goody, ARNP
• Kartik Gopal, PA
• Jorge Konstantin Gorb, O.D.
• Edward Gordon Jr.

• Occupational Therapy Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.