Robert C. Goodwin MD LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

16361 Issued in CT

Legal business name

ROBERT C. GOODWIN MD LLC

Practice address

1726 Ellington Rd
South Windsor, CT 06074-2739

Phone

(860) 644-9191

Fax

(860) 644-9191

NPI assigned

Nov 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert C. Goodwin, M.D.

Title

Managing Member

Phone

(860) 644-9191

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1195948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195948800000",
    "number": "1366623951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742739",
            "telephone_number": "860-644-9191",
            "fax_number": "860-644-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742739",
            "telephone_number": "860-644-9191",
            "fax_number": "860-644-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C. GOODWIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-25",
        "last_updated": "2007-11-25",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "860-644-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CT",
            "license": "16361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2007; 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.