Audrey Goodjoin, NP
Individual provider Active NPI Family Nurse Practitioner · Fountain Inn, SC
NPI 1336767730 · NPPES record last updated Jul 1, 2024
Key facts
- NPI
- 1336767730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 23185 (SC)
- Practice address
- 200 N Nelson Dr
Fountain Inn, SC 29644-9021 - Phone
- (864) 522-6270
- Fax
- (864) 522-6275
- NPI assigned
- Jul 12, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210503001558 | SC | Practitioner - Nurse Practitioner | 4789093857 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Current |
Accepting new patients | |
| Prisma Health University Medical Group | Current |
Accepting new patients |
Locations
210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123
800 N A St
Easley, SC 29640
Phone (864) 855-0001
200 N Nelson Dr
Fountain Inn, SC 29644
Phone (864) 522-6270
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
209 Three Bridges Rd
Greenville, SC 29611
Phone (864) 220-4209
5 W Main St
Greenville, SC 29611
Phone (864) 522-5220
1 Doctors Dr
Greenville, SC 29605
Phone (864) 271-3354
300 W Front St
Liberty, SC 29657
Phone (864) 843-5605
717 SE Main St
Bldg A
Simpsonville, SC 29681
Phone (864) 522-5400
807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132
Interoperability endpoints
- agoodjoin173742@direct.ghs.myhfn.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23185 | SC | Yes |
Addresses
Primary practice location
200 N Nelson Dr
Fountain Inn, SC 29644-9021
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614
Other practice location 1
807 N Main St
Travelers Rest, SC 29690-1551
Phone (864) 834-5132
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP7519 | Medicaid | SC |
Other providers in Fountain Inn, SC
- Generations Group Homes of Greenville, Inc
- Generations Group Homes of Greenville, Inc
- Generations Group Homes of Greenville. Inc.
- Generations Residential Programs, Inc.
- Charles George Goldizen II
- Diana Mary Granger
- Grouphab
- H.O.P.E Medical Supplies
- Amy E Handel
- Vicki Hardee
All providers in Fountain Inn, SC · Family Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.