Jessica Smith Goodman, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F06201620 Issued in NC

Practice address

111 S Salisbury GQ Ave
Granite Quarry, NC 28146-8150

Phone

(704) 279-1679

NPI assigned

Nov 16, 2020

Last updated

Nov 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgoodman12789@carolinashealthcaresystem.direct-ci.com
• Direct secure messaging: jgoodman851645@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GQ Internal Medicine and Pediatrics PLLC

  • Internal Medicine Physician
  • Salisbury, NC
  • NPI 1699540203
  Medicare reassignment NPD
• Novant Medical Group, Inc.

  dba Mid Carolina Cardiology

  • Interventional Cardiology Physician
  • Charlotte, NC
  • NPI 1205836434
  NPD (past)

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1225630080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S SALISBURY GQ AVE",
            "city": "GRANITE QUARRY",
            "state": "NC",
            "postal_code": "281468150",
            "telephone_number": "704-279-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JESSICA",
        "middle_name": "SMITH",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "F06201620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgoodman851645@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "111 S Salisbury Gq Ave",
            "city": "Granite Quarry",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281468150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Caron, MD
• James Andrew Caudill, RPH
• Faith Howell
• J & a McPharmacy Inc (Price Pharmacy)
• Susan W. Lankford, SLP
• Robert Ogden, D.D.S.
• Quality Care of Rowan County LLC

• Nurse Practitioner in Granite Quarry, NC
• Providers in Granite Quarry, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.