Andrea D. Goodwin, M.D.

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

License

17693 Issued in MS

Practice address

4715 24TH PL
Meridian, MS 39305

Phone

(601) 696-6736

Fax

(601) 696-6778

NPI assigned

Nov 18, 2005

Last updated

Jul 21, 2022By 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 2

Addresses

Other identifiers 2

Other names 1

• Dr. Andrea D. Dukes Former name

Medicare fee-for-service enrollment

Enrolled in MS, ME, TN, GA, AL, CT, WI, IL, NH9 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 9

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Quality of Life Health Services Inc

  dba Quality of Life Health Complex

  • Community Health Clinic/Center
  • Gadsden, AL
  • NPI 1447200977
  Medicare reassignment NPD
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661

  ME, MS

  Medicare reassignment
• Livwell Clinic PLLC

  dba LivWell Clinic

  • Family Medicine Physician
  • Meridian, MS
  • NPI 1427831973
  Authorized official Same address or phone
• Openloop Healthcare Partners Colorado, PC

  • General Practice Physician
  • Denver, CO
  • NPI 1912678012
  NPD
• Openloop Healthcare Partners Wisconsin, SC

  • General Practice Physician
  • Madison, WI
  • NPI 1083371629
  NPD
• Quality of Life Health Services, Inc

  dba Calhoun Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Anniston, AL
  • NPI 1013339209
  NPD
• Quality of Life Health Services, Inc

  dba Cleburne Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Heflin, AL
  • NPI 1467620989
  NPD
• Father of Waters Emergency Physicians LLC

  • Emergency Medicine Physician
  • De Kalb, MS
  • NPI 1194020248
  NPD (past)
• McLemore Emergency Physicians

  • Emergency Medicine Physician
  • Meridian, MS
  • NPI 1427007483
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Imaging Resource Centers LTD

  • Mobile Radiology Clinic/Center
  • Miamisburg, OH
  • NPI 1003855909
  NPD (past)
• Reliantmd Telehealth Group PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1447827456
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1285616870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 24TH PL",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393051686",
            "telephone_number": "601-696-6736",
            "fax_number": "601-696-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 24TH PL",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39305",
            "telephone_number": "601-696-6736",
            "fax_number": "601-696-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014116",
            "country_code": "US",
            "telephone_number": "601-703-9260",
            "fax_number": "601-703-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "ANDREA",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17693",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "MS",
            "license": "17693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00071956",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00755091",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DUKES",
            "middle_name": "D.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Summer L Goldman
• Gloria F Gomez, M.D.
• Amy M Goodin, PA-C
• Barbara B. Goodman, M.D.
• Perry Jay Goodman, M.D.
• Aurthur Goodwin, LPC
• Nekesha Johnnyette Gordon Crowell
• Gary G. Gordon, D.O.
• Jessica E Gordon, D.O.
• Andrea Gore

• Obesity Medicine (Family Medicine) Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Obesity Medicine (Family Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.