Marie Goodwin, MSN FNP-C
Individual provider Active NPI Family Nurse Practitioner · Boydton, VA
NPI 1174976542 · NPPES record last updated Jan 22, 2019
Key facts
- NPI
- 1174976542
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024173918 (VA)
- Practice address
- 380 Washington St
Boydton, VA 23917-3415 - Phone
- (434) 738-6420
- Fax
- (434) 738-6054
- NPI assigned
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Piedmont Access to Health Services Inc
Practice addresses (Care Compare)
380 Washington St
Boydton, VA 23917-3415
Phone (434) 738-6420
Hospital & facility affiliations
- Amedisys Home Health
- 1St Care Home Health South Boston
- Community Memorial Hospital
- Sentara Halifax Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161019001011 | VA | Practitioner - Nurse Practitioner | 2466740790 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0349979 | SD | MD | Family Nurse Practitioner |
| 0024173918 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Access to Health Services, Inc | Current |
Accepting new patients | |
| Piedmont Access to Health Services, Inc | Current | Accepting new patients | |
| Piedmont Access to Health Services, Inc | Current |
Accepting new patients | |
| Piedmont Access to Health Services Inc | Past | Accepting new patients |
Locations
380 Washington St
Boydton, VA 23917
Phone (434) 738-6102
705 Main St
Danville, VA 24541
Phone (434) 791-4122
Interoperability endpoints
- marie.goodwin@paths.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R0349979 | SD | |
| Family Nurse Practitioner | 363LF0000X | 0024173918 | VA | Yes |
Addresses
Primary practice location
380 Washington St
Boydton, VA 23917-3415
Mailing address
380 Washington St
Boydton, VA 23917-3415
Phone (434) 738-6420
Other providers in Boydton, VA
- Samantha Lynn Dean
- Charles Joseph Devine III
- DMV Family Care Services
- David William Eason
- Efficient Transportation Services
- Carolyn Shores Hoyle
- Jan L Hundley
- Willoughby Shelton Hundley III
- Robin H. Jennings
- Journey to Peace, LLC
All providers in Boydton, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.