Carresha Goodlow

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

2701437960 Issued in MI

Legal business name

CARRESHA GOODLOW

Practice address

820 Main St
Norway, MI 49870-1250

Phone

(731) 444-2577

NPI assigned

Nov 22, 2016

Organization subpart

No

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

Authorized official

Name

Carresha Charmaine GoodlowNPI 1114478542

Title

C.E.O

Phone

(731) 444-2577

Specialties & licenses 1

Addresses

Other names 1

• Charmaine cain hair replacement center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carresha Goodlow

  • Prosthetics Case Management
  • Iron, MI
  • NPI 1114478542
  NPD (past) Authorized official

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1154864213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6561",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532060561",
            "telephone_number": "731-444-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 MAIN ST",
            "city": "NORWAY",
            "state": "MI",
            "postal_code": "498701250",
            "telephone_number": "731-444-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRESHA GOODLOW",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "GOODLOW",
        "authorized_official_first_name": "CARRESHA",
        "authorized_official_middle_name": "CHARMAINE",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "731-444-2577"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "2701437960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charmaine cain hair replacement center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alex Barker, PHARMD
• Bellin Health Iron Mountain Inc
• Larry G Bourdeau, DDS
• Aileen N Brouwer, O.D.
• Maggie Ann Carpenter, STUDENT/INTERN
• Luke Joseph Cayemberg, MD
• Tyler Allen Chartier, O.D.
• Alexandra Constantini
• David B. Van Holla, M.D., PC
• David E Atkinson MD PC

• All providers in Norway, MI
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.