Active NPI
Meredith Pettit Goodwin, CNP
- Family Nurse Practitioner
- Santa Clara, CA
National Provider Identifier
1538592134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95014630
- Practice address
- 2005 De la Cruz Blvd Ste 271
Santa Clara, CA 95050-3031 - Phone
- (408) 313-4166
- Fax
- (408) 986-0354
- NPI assigned
- Aug 19, 2013
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95014630 | CA | Primary |
Addresses
Primary practice location
2005 De la Cruz Blvd Ste 271
Santa Clara, CA 95050-3031
Mailing address
2005 De la Cruz Blvd Ste 271
Santa Clara, CA 95050-3031
Phone (408) 313-4166
Other names 1
- Meredith Leigh Pettit, Evenson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mpettit213300@excellian.direct.allina.com | Direct |
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
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95014630 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1538592134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 DE LA CRUZ BLVD STE 271",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950503031",
"telephone_number": "408-313-4166",
"fax_number": "408-986-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 DE LA CRUZ BLVD STE 271",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950503031",
"telephone_number": "408-313-4166",
"fax_number": "408-986-0354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "MEREDITH",
"middle_name": "PETTIT",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-19",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95014630",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpettit213300@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "280 Smith Ave N",
"address_2": "Ste 220",
"city": "St Paul",
"state": "MN",
"country_code": "US",
"postal_code": "551022459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MEREDITH",
"last_name": "PETTIT, EVENSON",
"middle_name": "LEIGH",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.