Individual provider Active NPI

Jennifer Goodwin, FNP

  • Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1205427523
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
218490 Issued in LA
Practice address
1500 Line Ave
Shreveport, LA 71101-4639
Phone
(318) 629-5555
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 218490 LA Primary
Family Nurse Practitioner 363LF0000X 218490 LA

Addresses

Primary practice location

1500 Line Ave
Shreveport, LA 71101-4639

Mailing address

1500 Line Ave Ste 200
Shreveport, LA 71101-4643
Phone (318) 629-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221108002043 LA Practitioner - Nurse Practitioner 7517334303 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care LLC CurrentSince Feb 26, 2023 Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince Feb 26, 2023 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Aug 30, 2024 Accepting new patients

Locations

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jennifer.goodwin.p1@direct.sil.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1205427523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014643",
            "telephone_number": "318-629-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014639",
            "telephone_number": "318-629-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "218490",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "218490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.