Robert Clare Goodwin, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

16361 Issued in CT

Practice address

1726 Ellington Rd
South Windsor, CT 06074-2739

Phone

(860) 644-9191

Fax

(860) 644-9191

NPI assigned

Mar 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Intercommunity, Inc.

  • Primary Care Clinic/Center
  • East Hartford, CT
  • NPI 1073548533
  NPD (past)
• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1962896548
  NPD (past)
• Medoptions Behavioral Health Assoc, LLC

  • Nurse Practitioner
  • Old Saybrook, CT
  • NPI 1588604060

  Psychiatry

  NPD (past)
• The Connection Inc.

  • Adult Mental Health Clinic/Center
  • New Haven, CT
  • NPI 1154387652
  NPD (past)
• The Connection Inc.

  • Adult Mental Health Clinic/Center
  • New Haven, CT
  • NPI 1992823538
  NPD (past)

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1215051164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742739",
            "telephone_number": "860-644-9191",
            "fax_number": "860-644-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742739",
            "telephone_number": "860-644-9191",
            "fax_number": "860-644-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "ROBERT",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-18",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "16361",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "016361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON-PAR ANTHEM ID",
            "identifier": "010016361CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nakia M Gilbert, RN
• Rachel Lina Gima, CNM
• Gladys' Counseling Place, PLLC-Where Life'S Moments Make You Stronger
• Colleen Golnik, LMFT
• Michelle Marguerite Gonzalez, APRN
• Wendy K Goudreault, LCSW
• Sarah Graceffa, M.D.
• Andrea M Grant, LCSW
• Julian Grant, RN
• Virginia Graves, APRN

• Specialist in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.