Jessica Goodman, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Lowell, IN
NPI 1497477285 · NPPES record last updated Sep 19, 2022
Key facts
- NPI
- 1497477285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 71013017A (IN)
- Practice address
- 2068 Lucas Pkwy
Lowell, IN 46356-2169 - Phone
- (219) 690-7025
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Heartland Behavioral Health Inc
Practice addresses (Care Compare)
2068 Lucas Pkwy
Lowell, IN 46356-2169
Phone (219) 690-7025
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241230002065 | IN | Practitioner - Nurse Practitioner | 8224565403 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71013017A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
| 71013017B | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartland Behavioral Health Inc | Current |
Accepting new patients |
Locations
101 Beverly Dr
Chesterton, IN 46304
Phone (219) 690-7025
2068 Lucas Pkwy
Lowell, IN 46356
Phone (219) 690-7025
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71013017B | IN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71013017A | IN | Yes |
Addresses
Primary practice location
2068 Lucas Pkwy
Lowell, IN 46356-2169
Mailing address
2068 Lucas Pkwy
Lowell, IN 46356-2169
Phone (219) 690-7025
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000000 | Other | NONE YET ASSIGNED |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jessica@heartlandrecoverycenter.com |
Other providers in Lowell, IN
- Kenneth Charles Floyd
- Christian James Gabrano
- Alejandra Garcia
- Angela Jean Gard
- Alexis Geary
- Gordana Gorgijovski
- Diana Lynn Greenberg
- Hancock Regional Hospital
- Jeanine Marie Harley
- Heartland Behavioral Health Inc
All providers in Lowell, IN · Psychiatric/Mental Health Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.