Individual provider Active NPI

Alyssa M Goodwin, MEDICAL STUDENT

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1194426973
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
303 E Superior St
Chicago, IL 60611-3015
Phone
(313) 503-4851
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

303 E Superior St
Chicago, IL 60611-3015

Mailing address

303 E Superior St
Chicago, IL 60611-3015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240520002845 MI Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 9931541166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1194426973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113015",
            "telephone_number": "313-503-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "ALYSSA",
        "middle_name": "M",
        "credential": "MEDICAL STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.