Lakesha Monique Goodwin, AGPCNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APN31196 Issued in TN

Practice address

5511 Virginia Way
Ste 300
Brentwood, TN 37027-7611

Phone

(615) 994-1000

Fax

(615) 994-0100

NPI assigned

Feb 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, OR2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1003560715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 VIRGINIA WAY",
            "address_2": "STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277611",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 VIRGINIA WAY",
            "address_2": "STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277611",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "249 Central Park Avenue",
            "address_2": "Suite 300-161",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234623099",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "LAKESHA",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024186832",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN31196",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024186832",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "APN31196",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "APN31196",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024186832",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024186832",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN31196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Gomez, MSN, FNP-BC
• Aimee Gonzalez
• Arianna Gonzalez
• James Kenneth Goodlad III, PHD
• Dornisha Darra Goodrich
• Cameron L Gordon, PH.D.
• Georgina Olivia Gordon
• Richard William Gorman, LPC-MHSP (TEMP)
• Edward Gorny, CNIM
• Eric Gott, LPC (TEMP)

• Primary Care Nurse Practitioner in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.