Charlotte Whitehurst Goodwyn, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5005885 Issued in NC

Practice address

3485 N. Main Street
Farmville, NC 27858

Phone

(252) 753-3193

NPI assigned

Oct 30, 2012

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

Enrolled in NC

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Farmville Internal Medicine PAGroup PAC ID 8325037575, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charlotte.goodwyn.1@32498.direct.athenahealth.com

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

• Farmville Internal Medicine PA

  • Family Medicine Physician
  • Farmville, NC
  • NPI 1710942610
  Medicare reassignment Care Compare group NPD
• Greenville Health Care Center,PA

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1851341408
  NPD (past)

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1104170166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 FERNCLIFF LN",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278865629",
            "telephone_number": "252-883-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 N. MAIN STREET",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-753-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWYN",
        "first_name": "CHARLOTTE",
        "middle_name": "WHITEHURST",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farmville Discount Drug, Inc.
• Farmville Internal Medicine PA
• William Chavis Fields Jr., CFO
• Forris IV Care Transportation LLC
• Staci Hobgood Garner, PHARM D
• Ami Gopal
• Jessica Grady, PHARMD
• Greater Care Homes LLC
• Brenda Green
• Guardian Angels Home Healthcare, Inc

• Nurse Practitioner in Farmville, NC
• Providers in Farmville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.