Jordan Lea Goad, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN.21159 Issued in SC

Practice address

1483 Tobias Gadson Blvd Ste 107
Charleston, SC 29407-4795

Phone

(843) 745-5153

Fax

(843) 766-8606

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lowcountry Wellness Center LLC

  • Primary Care Clinic/Center
  • Charleston, SC
  • NPI 1639604929
  NPD

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1457815664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 300",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615833",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 TOBIAS GADSON BLVD STE 107",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074795",
            "telephone_number": "843-745-5153",
            "fax_number": "843-766-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOAD",
        "first_name": "JORDAN",
        "middle_name": "LEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN282704",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "APN.21159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Kyle Glover, PHARMD
• Elizabeth A. Glover
• Kelsey Glover, MD
• Tiffany D Glover
• John W Gnann Jr., MD
• Jacob Goatley, MD
• Ahaileya Gobin, RN
• Josiah David Godbolt, M.A. CF-SLP
• Krista Godek, LISW-CP
• Nicole Godfrey, NP

• Psychiatric/Mental Health Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.