Jennifer Goodin, FNP

Key facts

NPI

1174129381

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

4704281359 (MI)

Practice address

18 Market St Ste C
Mount Clemens, MI 48043-7403

Phone

(586) 783-2222

Fax

(583) 783-6380

NPI assigned

Dec 11, 2020

Sex

Female

Sole proprietor

No

Organizations & group practices 6

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.

• Mycare Health Center Federally Qualified Health Center (FQHC) · Mount Clemens, MI · NPI 1265749683
  Medicare reassignment Care Compare group NPD MI
• Specialists in Rehabilitation Medicine PC Physical Medicine & Rehabilitation Physician · Rochester, MI · NPI 1336114537
  Medicare reassignment NPD MI
• Mycare Health Center Federally Qualified Health Center (FQHC) · Center Line, MI · NPI 1770284564
  Care Compare group NPD
• Mycare Health Center Federally Qualified Health Center (FQHC) · Clinton Township, MI · NPI 1639573033
  Care Compare group NPD (past)
• Mycare Health Center Federally Qualified Health Center (FQHC) · Center Line, MI · NPI 1811391212
  Care Compare group NPD (past)
• George J Carley DO PC Family Medicine Physician · Port Huron, MI · NPI 1528173812
  NPD

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mycare Health Center (6 clinicians)

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.31 of 100 (group)

Quality

73.34

Promoting interoperability

64

Improvement activities

40

Cost

52.64

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10018231
• Direct secure messaging: jgoodin1130348@direct.hfhs.org
• Direct secure messaging: jennifergoodin@mchc.allscriptsdirect.net

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 21, 2024.

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1174129381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1943 HOLLAND AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601519",
            "telephone_number": "810-357-4945",
            "fax_number": "810-985-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 MARKET ST STE C",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480437403",
            "telephone_number": "586-783-2222",
            "fax_number": "583-783-6380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 E 10 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Center Line",
            "state": "MI",
            "postal_code": "480151168",
            "country_code": "US",
            "telephone_number": "586-756-7777",
            "fax_number": "586-756-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704281359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Mount Clemens, MI · Family Nurse Practitioner in Michigan