Stephanie Gooden, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-09347 Issued in NC

Practice address

300A E McKay St
Elizabethtown, NC 28337-9037

Phone

(910) 862-5500

Fax

(910) 862-5501

NPI assigned

Aug 26, 2019

Last updated

Oct 8, 2019By 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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bladen Healthcare LLCGroup PAC ID 6800967969, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Fear Valley-Bladen County Hospital Hospital, Elizabethtown, NC, CCN 341315
• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgooden73374@capefearvalley.direct-ci.com

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.

• Bladen Healthcare LLC

  dba Cape Fear Valley Bladen County Hospital

  • Critical Access Hospital
  • Elizabethtown, NC
  • NPI 1558537282
  Medicare reassignment Care Compare group NPD
• Bladen Healthcare LLC

  dba CFV Primary Care-Vineland Family Medicine

  • Rural Health Clinic/Center
  • Whiteville, NC
  • NPI 1821764390
  NPD
• Made to Mother Lactation, PLLC

  dba Wonderfully Made Women's Health

  • Physician Assistant
  • Holly Springs, NC
  • NPI 1982490751
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bladen Healthcare LLC

  dba Cape Fear Valley Bladen County Hospital

  • Critical Access Hospital
  • Elizabethtown, NC
  • NPI 1558537282
  Care Compare affiliation
• Southeastern Regional Medical Center

  dba UNC Health Southeastern

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774
  Care Compare affiliation

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1578110482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5934 TWISTED HICKORY RD",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283375254",
            "telephone_number": "910-991-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300A E MCKAY ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283379037",
            "telephone_number": "910-862-5500",
            "fax_number": "910-862-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODEN",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09347",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-09347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawnn Flowers, PHARMD
• Gene Anderson Drug Store Inc.
• Sidrah Ghaffar, DO
• Mollie B Glenn, O.D.
• Luke Austin Gooden
• Julia Hall Goodwin, RPH
• Thomas Goodwin
• Goshen Medical Center, Incorporated (Goshen Medical Center - Elizabethtown)
• Tara L Govan, LCAS 1917
• Ashley Ann Graham Jones, FNP-C

• Physician Assistant in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.