Individual provider Active NPI

Ashly Jasmine Goodwill, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1104110766
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
304022 Issued in NY
Practice address
16 Glasser St
Rochester, NY 14606
Phone
(716) 771-8690
NPI assigned
Jun 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 304022 NY Primary

Addresses

Primary practice location

16 Glasser St
Rochester, NY 14606

Mailing address

16 Glasser St
Rochester, NY 14606
Phone (716) 771-8690

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
304022NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1104110766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GLASSER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14606",
            "telephone_number": "716-771-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 GLASSER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14606",
            "telephone_number": "716-771-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWILL",
        "first_name": "ASHLY",
        "middle_name": "JASMINE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "304022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.