Individual provider Active NPI

Catherine M Goodwyn

  • Dentist
  • Orchard Park, NY
National Provider Identifier
1386687382
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041532 Issued in NY
Practice address
4949 Ellicott Rd
Orchard Park, NY 14127-3357
Phone
(716) 662-4715
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 041532 NY Primary

Addresses

Primary practice location

4949 Ellicott Rd
Orchard Park, NY 14127-3357

Mailing address

4949 Ellicott Rd
Orchard Park, NY 14127-3357
Phone (716) 662-4715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1386687382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 ELLICOTT RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273357",
            "telephone_number": "716-662-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 ELLICOTT RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273357",
            "telephone_number": "716-662-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWYN",
        "first_name": "CATHERINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.