NPIMap

Individual provider Active NPI

Ronelle Goodwin, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1326464058
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
18685 Issued in SC
Practice address
11 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone
(803) 434-4300
NPI assigned
Mar 5, 2014
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 18685 SC Primary

Addresses

Primary practice location

11 Richland Medical Park Dr
Columbia, SC 29203-6863

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

1333 Taylor St
Suite 5-F
Columbia, SC 29201-2923
Phone (803) 748-9966

Other identifiers 1

IdentifierTypeStateIssuer
NP3215MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140731000037 SC Practitioner - Nurse Practitioner 4486870227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

1333 Taylor St
Suite 5F
Columbia, SC 29201-2951
Phone (803) 748-9966

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Dec 9, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 9, 2016 Accepting new patients

Locations

11 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-4506

1333 Taylor St
Ste 5F
Columbia, SC 29201
Phone (803) 733-9598

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

2739 Laurel St
Ste 1A
Columbia, SC 29204
Phone (803) 799-3737

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

9 Richland Medical Park Dr
Ste 450
Columbia, SC 29203
Phone (803) 434-8800

Interoperability endpoints

  • Direct secure messaging: rgoodwin379887@direct.ghs.myhfn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1326464058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Taylor St",
            "address_2": "Suite 5-F",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012923",
            "country_code": "US",
            "telephone_number": "803-748-9966",
            "fax_number": "803-748-7174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "RONELLE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-05",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "18685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3215",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.