Lynn E Goodwin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1481ATI Issued in OR

Practice address

425 N Main
Myrtle Creek, OR 97457

Phone

(541) 863-5258

Fax

(541) 863-6000

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lynn E Goodwin OD PC

  • Optometrist
  • Myrtle Creek, OR
  • NPI 1548439185
  Medicare reassignment Authorized official
• Makayla Adams OD PC

  • Optometrist
  • Myrtle Creek, OR
  • NPI 1437942638
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1407968472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6006",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "97457",
            "telephone_number": "541-863-5258",
            "fax_number": "541-863-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N MAIN",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "97457",
            "telephone_number": "541-863-5258",
            "fax_number": "541-863-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "LYNN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-03-28",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1481ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226175",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tyler Dearing, PHARM.D
• Oswald John Fett
• Mindy Frye
• Vilca Fauiki Havili, PA-C
• Mark Michael Herscher, D.O.
• Cameron Hill, PHARMD
• Ana Lou Pia Holk
• Marcus Scott Janky, PTA

• Optometrist in Myrtle Creek, OR
• Providers in Myrtle Creek, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.