Active NPI
Jacob Edwin Goodwin, PHARMD
- Pharmacist
- Savannah, GA
National Provider Identifier
1215286158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 25367
- Practice address
- 7360 Skidaway Rd
Savannah, GA 31406 - Phone
- (912) 658-1440
- NPI assigned
- Sep 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12538 | SC | |
| Pharmacist | 183500000X | 25367 | GA | Primary |
Addresses
Primary practice location
7360 Skidaway Rd
Savannah, GA 31406
Mailing address
7360 Skidaway Rd
Savannah, GA 31406
Phone (912) 658-1440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25367 | GA | MD | Pharmacist |
| 12538 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1215286158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7360 SKIDAWAY RD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31406",
"telephone_number": "912-658-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7360 SKIDAWAY RD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31406",
"telephone_number": "912-658-1440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "JACOB",
"middle_name": "EDWIN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-06",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "12538",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "25367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.