Active NPI
Amy Morgan Goode, PAC
- Physician Assistant
- Princeton, WV
National Provider Identifier
1518083732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 365 Courthouse Road
Princeton, WV 24740 - Phone
- (304) 425-3922
- Fax
- (304) 487-0229
- NPI assigned
- Mar 21, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
365 Courthouse Road
Princeton, WV 24740
Mailing address
365 Courthouse Road
Princeton, WV 24740
Phone (304) 425-3922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810017069 | Medicaid | WV |
Other names 1
- Amy Morgan Bradford
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
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1518083732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 COURTHOUSE ROAD",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-425-3922",
"fax_number": "304-487-0229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 COURTHOUSE ROAD",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-425-3922",
"fax_number": "304-487-0229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODE",
"first_name": "AMY",
"middle_name": "MORGAN",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810017069",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "BRADFORD",
"middle_name": "MORGAN",
"credential": "PAC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.