Active NPI
Jeremiah Ronald Goodwin, PT
- Physical Therapist
- Sanford, FL
National Provider Identifier
1013965763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 28252
- Practice address
- 950 S Mellonville Ave
Sanford, FL 32771-2237 - Phone
- (407) 322-8566
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10115 | TN | |
| Physical Therapist | 225100000X | 28252 | FL | Primary |
Addresses
Primary practice location
950 S Mellonville Ave
Sanford, FL 32771-2237
Mailing address
950 S Mellonville Ave
Sanford, FL 32771-2237
Phone (407) 322-8566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28252 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duncan Wells PC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1013965763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 S MELLONVILLE AVE",
"city": "SANFORD",
"state": "FL",
"postal_code": "327712237",
"telephone_number": "407-322-8566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 S MELLONVILLE AVE",
"city": "SANFORD",
"state": "FL",
"postal_code": "327712237",
"telephone_number": "407-322-8566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "JEREMIAH",
"middle_name": "RONALD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2021-05-21",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "10115",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "28252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanford, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.