Amanda Lynn Goodno, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

32741 Issued in SC

Practice address

500 N 12TH St
West Columbia, SC 29169-6502

Phone

(803) 217-0415

Fax

(803) 939-1650

NPI assigned

Jul 7, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10781/brand/1/csg/1/fhir/r4

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.

• Eau Claire Cooperative Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Winnsboro, SC
  • NPI 1003113168
  NPD (past)
• Eau Claire Cooperative Health Center, Inc.

  • General Practice Dentistry
  • Columbia, SC
  • NPI 1457740789
  NPD (past)

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1124330139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3788",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292303788",
            "telephone_number": "803-733-5969",
            "fax_number": "803-217-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 12TH ST",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291696502",
            "telephone_number": "803-217-0415",
            "fax_number": "803-939-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODNO",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "32741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327417",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Edward Golob, OTR/L
• Victor Anselmo Gomez, PA-C
• Aimee Yates Gondi, CRNA
• Gautham Gondi, MD
• Catherine Grace Goodman
• Ebony Goodson
• Christina Gore
• Chelsea Gorski
• Ana Gosnell, NP
• Caleb Gosnell

• Pediatrics Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.