Individual provider Active NPI

Andy Goodnight

  • Occupational Therapy Assistant
  • Morris, OK
National Provider Identifier
1235760976
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1078 Issued in OK
Practice address
16993 Elm LN
Morris, OK 74445-2837
Phone
(918) 527-3394
NPI assigned
Jan 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1078 OK Primary

Addresses

Primary practice location

16993 Elm LN
Morris, OK 74445-2837

Mailing address

16993 Elm LN
Morris, OK 74445-2837
Phone (918) 527-3394

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

LicenseStateTypeSpecialty
1078OKMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1235760976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16993 ELM LN",
            "city": "MORRIS",
            "state": "OK",
            "postal_code": "744452837",
            "telephone_number": "918-527-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16993 ELM LN",
            "city": "MORRIS",
            "state": "OK",
            "postal_code": "744452837",
            "telephone_number": "918-527-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODNIGHT",
        "first_name": "ANDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.