Individual provider Active NPI

Amanda Jackson Goodwin, PAC

  • Medical Physician Assistant
  • Danville, KY
National Provider Identifier
1093881393
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA912 Issued in KY
Practice address
600 W Walnut St
Danville, KY 40422-1309
Phone
(859) 238-5530
Fax
(859) 238-5380
NPI assigned
Nov 28, 2006
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA912 KY Primary

Addresses

Primary practice location

600 W Walnut St
Danville, KY 40422-1309

Mailing address

600 W Walnut St
Danville, KY 40422-1309
Phone (859) 238-5530

Other practice location 1

217 S 3rd St
Danville, KY 40422-1823
Phone (859) 699-2991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20080104000049 KY Practitioner - Physician Assistant 0941380802 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

216 W Walnut St
Danville, KY 40422-1832

217 S 3Rd St
Danville, KY 40422-1823

464 Linden Ave
Harrodsburg, KY 40330-1882
Phone (859) 734-5441

466 Linden Ave
Harrodsburg, KY 40330-1841

470 Linden Ave
Suite B
Harrodsburg, KY 40330-1871
Phone (859) 733-5890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc Medical CurrentSince Feb 23, 2026 Accepting new patients
Ephraim McDowell Health Resource, Inc Medical CurrentSince Feb 23, 2026 Accepting new patients
The James B. Haggin Memorial Hospital Inc CurrentSince Feb 23, 2026 Accepting new patients
The James B. Haggin Memorial Hospital Inc CurrentSince Feb 23, 2026 Accepting new patients
Empact Midwest LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

1541 Lebanon Rd
Ste 1
Danville, KY 40422
Phone (859) 236-3208

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

464 Linden Ave
Harrodsburg, KY 40330
Phone (859) 734-5441

110 Metker Trl
Stanford, KY 40484
Phone (606) 365-3360

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1093881393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W WALNUT ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221309",
            "telephone_number": "859-238-5530",
            "fax_number": "859-238-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W WALNUT ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221309",
            "telephone_number": "859-238-5530",
            "fax_number": "859-238-5380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "KY",
            "postal_code": "404221823",
            "country_code": "US",
            "telephone_number": "859-699-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "AMANDA",
        "middle_name": "JACKSON",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.