Alysson Miller Goodwin, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3904 Issued in SC

Practice address

29 Race St
Charleston, SC 29403-4634

Phone

(318) 792-1696

NPI assigned

Apr 16, 2012

Sex

Female

Sole proprietor

Yes

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.

• Alysson Goodwin, Otr/L

  • Pediatric Occupational Therapist
  • Mount Pleasant, SC
  • NPI 1669025847
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

Specialties & licenses 1

Addresses

Other names 1

• Alysson Mavis Miller Former name

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1013274075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 RACE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294034634",
            "telephone_number": "318-792-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 RACE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294034634",
            "telephone_number": "318-792-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "ALYSSON",
        "middle_name": "MILLER",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSON",
            "last_name": "MILLER",
            "middle_name": "MAVIS",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David T Goodman, MD
• Jontay Goodman
• Kassi Lynn Goodman, LPC
• Mary L Goodman, DNP
• Peter D Goodnight, M.D.
• Andrew J Goodwin, M.D.
• Ashtan Michaela Goodwin
• Dana Goodwin, LISW-CP
• Payton Goodwin
• Morgan Goodyear, MD

• All providers in Charleston, SC
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.