Active NPI
Nicole Goodwin, PT
- Physical Therapist
- Los Gatos, CA
National Provider Identifier
1487713376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT24672
- Practice address
- 291 E Main St Ste E
Los Gatos, CA 95030-6137 - Phone
- (408) 354-2223
- Fax
- (408) 354-2228
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT24672 | CA | Primary |
Addresses
Primary practice location
291 E Main St Ste E
Los Gatos, CA 95030-6137
Mailing address
291 E Main St Ste E
Los Gatos, CA 95030-6137
Phone (408) 354-2223
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT24672 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optm Sports & Physical Therapy, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1487713376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 E MAIN ST STE E",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950306137",
"telephone_number": "408-354-2223",
"fax_number": "408-354-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 E MAIN ST STE E",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950306137",
"telephone_number": "408-354-2223",
"fax_number": "408-354-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "NICOLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT24672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.