Active NPI
Mary Ann Goodrich
- Driver
- Woodville, MS
National Provider Identifier
1235704172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 801901868
- Practice address
- 66 Hill Street
Woodville, MS 39669 - Phone
- (601) 213-7055
- Fax
- (601) 888-6876
- NPI assigned
- May 24, 2021
- Last updated
- May 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 801901868 | MS | Primary |
Addresses
Primary practice location
66 Hill Street
Woodville, MS 39669
Mailing address
PO Box 1594
Woodville, MS 39669-1594
Phone (601) 213-7055
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 801901868 | MS | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1235704172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1594",
"city": "WOODVILLE",
"state": "MS",
"postal_code": "396691594",
"telephone_number": "601-213-7055",
"fax_number": "601-888-6876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 HILL STREET",
"city": "WOODVILLE",
"state": "MS",
"postal_code": "39669",
"telephone_number": "601-213-7055",
"fax_number": "601-888-6876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "MARY",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-24",
"last_updated": "2021-05-24",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "MS",
"license": "801901868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodville, MS
- Family Health Care Clinic, Inc.
- Family Health Care Clinic, Inc.
- Field Memorial Community Hospital (FHS Express Pharmacy)
- Field Memorial Community Hospital (FMCH Catching's Clinic)
- Field Memorial Community Hospital (Catchings Clinic)
- Granger LLC
- Melinda Adlisha Hollins
- Gary Russell Johnson, PT
- Jennifer Whetstone Lanehart, NP
- Robert L Lewis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.