Shanice Carnella Goodman-Taylor

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703128440 Issued in MI

Practice address

6800 W Maple Rd
West Bloomfield, MI 48322-2792

Phone

(248) 788-5300

NPI assigned

Jun 20, 2024

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

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1063256519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42941 NORTHVILLE PLACE DR APT 1612",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672924",
            "telephone_number": "313-598-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222792",
            "telephone_number": "248-788-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN-TAYLOR",
        "first_name": "SHANICE",
        "middle_name": "CARNELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703128440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Goodman
• Emilie Goodnight, OTL
• Cheryl Abel Goodwin, LMSW
• Lisa Goolsby
• Emily Ann Gopoian

• Licensed Practical Nurse in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.