Beronica Goodwin

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2-055526 Issued in AL

Practice address

1102B Suite #2 4TH Ave SE
Decatur, AL 35601

Phone

(356) 822-1300

NPI assigned

Jul 28, 2016

Last updated

Nov 15, 2022By the provider in NPPES

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

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenity Caregivers LLC

  • Religious Nonmedical Health Care Institution
  • Decatur, AL
  • NPI 1851743181
  NPD (past) Authorized official

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1497208250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 SEWELL RD",
            "city": "TRINITY",
            "state": "AL",
            "postal_code": "356736625",
            "telephone_number": "256-345-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102B SUITE #2 4TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35601",
            "telephone_number": "356-822-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "BERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AL",
            "license": "16395",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AL",
            "license": "2-055526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Goldby, C.R.N.P
• Mary Sloan Golden, PHARM D
• Callie C Gooch
• Good Hope Dental Center PC (Clark Family Dentistry)
• Taylor Liane Goodpastor, CRNP
• Kareen Vincent Goodwin, DPH
• Kathy S Goodwin, MS
• Jennifer Grace Gourlay, DMD
• Blake Lee Gowen, R.PH.
• Grace Health and Wellness Family Clinic

• Licensed Practical Nurse in Decatur, AL
• Providers in Decatur, AL by specialty
• Licensed Practical Nurse in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.