Johnnie N Bradley-Goodman, APRN, PMHNP - BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN9215272 Issued in FL

Practice address

84 W Lowder St
Macclenny, FL 32063-2638

Phone

(352) 374-5615

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639
  NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Medical Specialists of Northeast Florida PLLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1285938936
  NPD
• Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Ocala, FL
  • NPI 1033850797
  NPD
• Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Gainesville, FL
  • NPI 1134287154
  NPD
• University of Florida Jacksonville Physicians Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1326208695
  NPD
• University of Florida Jacksonville Physicians Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1487814752
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1235398983
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1306322656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 W LOWDER ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632638",
            "telephone_number": "352-374-5615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "945 Grand St",
            "address_purpose": "LOCATION",
            "city": "Starke",
            "state": "FL",
            "postal_code": "320911821",
            "country_code": "US",
            "telephone_number": "904-964-8382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 SW 13th St",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326084006",
            "country_code": "US",
            "telephone_number": "352-374-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY-GOODMAN",
        "first_name": "JOHNNIE",
        "middle_name": "N",
        "credential": "APRN, PMHNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "APRN9215272",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9215272",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9215272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benso Gold Dental, P.a.
• Bio-Medical Applications of Florida, Inc.
• Amanda Jean Bondie
• Janie Boulware
• Tiffany Faye Braddy, APRN
• Brittany N Day, DDS, PA
• Angela Broadnax
• Jennifer K Brown, ARNP
• Robert Brown, PHARMD
• Scott Cales, PHARMD

• All providers in Macclenny, FL
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.