Amanda Goodwin, COTA

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

214317 Issued in TX

Practice address

4400 Walnut St
Greenville, TX 75401-5586

Phone

(903) 455-4618

NPI assigned

Oct 1, 2018

Last updated

Oct 1, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1245715747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 RAVINE ST",
            "city": "EMORY",
            "state": "TX",
            "postal_code": "754402433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 WALNUT ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015586",
            "telephone_number": "903-455-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "214317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Oaks Hospital, Inc.
• Gloria Rodarte Brun, M. D., P. a.
• Edward Augustus Glover IV, D.D.S.
• Jasmine Nathaly Gonzales
• Goodluck Homestead Enterprises LP
• Lauren Gordon, LCSW
• Goss Chiropractic & Wellness PLLC
• Erica Lynn Goss, PTA
• Mark G Goss, MD
• Thomas J. Goss, DC

• Geriatric Medicine (Family Medicine) Physician in Greenville, TX
• Providers in Greenville, TX by specialty
• Geriatric Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.