Jennifer Ross Goodwin, PNP-PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

864754 Issued in MS

Practice address

102 Medical Park
Hattiesburg, MS 39401-9080

Phone

(601) 261-5159

NPI assigned

Feb 4, 2020

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 50)

Interoperability endpoints

• Direct secure messaging: jgoodwin148204@directpatientrecord.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• Sumrall Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Sumrall, MS
  • NPI 1184694036
  Medicare reassignment NPD
• Hattiesburg Clinic PA

  dba Connections

  • Adolescent and Children Mental Health Clinic/Center
  • Hattiesburg, MS
  • NPI 1154410017
  NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Hattiesburg Community Dental Center

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1366468266
  NPD
• Hattiesburg High School Campus Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1427328889
  NPD
• Beaumont Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Beaumont, MS
  • NPI 1831166826
  NPD (past)
• Brooklyn Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, MS
  • NPI 1659348076
  NPD (past)
• Hattiesburg Clinic, PA

  dba Laurel Dialysis Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Laurel, MS
  • NPI 1245263540
  NPD (past)
• Hattiesburg High School and Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1760451777
  NPD (past)
• Hattiesburg Public School and Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1023087400
  NPD (past)
• Lumberton Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Lumberton, MS
  • NPI 1164499174
  NPD (past)

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1083246474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MEDICAL PARK",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394019080",
            "telephone_number": "601-261-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JENNIFER",
        "middle_name": "ROSS",
        "credential": "PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "864754",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "865754",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "865754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Linscott Gonsalves, CCC-SLP
• Kimberly Rogers Gonzales, ACNP
• Kenneth L Gooch, M.D.
• Adie Goodman
• Christina Lynn Goodridge, MD
• Kelly Goolsby, PHARMD
• Muhammad Hassan Naeem Goraya, M.D.
• Zoe Gore, AU.D.
• Jennifer Davis Goshorn, M.A. CCC-A
• Venkata Lakshmi Kalyani Gottemukkala

• Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.