Lynn E Goodwin OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1481ATI Issued in OR

Legal business name

LYNN E GOODWIN OD PC

Doing business as

Advanced Eyecare & The Eyewear Gallery

Practice address

425 N Main St
Myrtle Creek, OR 97457-0056

Phone

(541) 863-5258

Fax

(541) 863-6000

NPI assigned

Feb 28, 2008

Reactivated

May 1, 2024

Last updated

Jan 23, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lynn E Goodwin, O.D.NPI 1407968472

Title

Owner

Phone

(541) 863-5258

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Eyecare & The Eyewear Gallery Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lynn E Goodwin, OD

  • Optometrist
  • Myrtle Creek, OR
  • NPI 1407968472
  Medicare reassignment Authorized official
• Makayla Adams, OD

  • Optometrist
  • Myrtle Creek, OR
  • NPI 1790461911
  Medicare reassignment
• Christopher Lee Kelly, O.D.

  • Optometrist
  • Thief River Falls, MN
  • NPI 1801827266
  NPD (past)

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1548439185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6006",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974570056",
            "telephone_number": "541-863-5258",
            "fax_number": "541-863-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N MAIN ST",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974570056",
            "telephone_number": "541-863-5258",
            "fax_number": "541-863-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN E GOODWIN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "deactivation_date": "2024-04-11",
        "reactivation_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-863-5258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1481ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22617-5",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eyecare & The Eyewear Gallery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Laduke
• James A. Lawson Jr., DMD
• Lura Lynne Lemert, PT
• Tom Lin, MD
• Carrie Lovemark, L.AC.
• Makayla Adams OD PC (Advanced Eyecare & Eyewear Gallery)
• Mark M Herscher DO
• Amy L Martin
• Colleen Moran McGuire, RN
• Meridian Acupuncture LLC (Meridian Acupuncture)

• Optometrist in Myrtle Creek, OR
• Providers in Myrtle Creek, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.