Individual provider Active NPI

Rachel Lauren Goodwyn, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1093362170
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
57242 Issued in NM
Practice address
6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363
Phone
(505) 308-3145
Fax
(505) 308-3147
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 57242 NM Primary

Addresses

Primary practice location

6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363

Mailing address

6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363
Phone (505) 308-3145

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
57242NMMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1093362170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 ACADEMY RD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093363",
            "telephone_number": "505-308-3145",
            "fax_number": "505-308-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6709 ACADEMY RD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093363",
            "telephone_number": "505-308-3145",
            "fax_number": "505-308-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWYN",
        "first_name": "RACHEL",
        "middle_name": "LAUREN",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "57242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.