Individual provider Active NPI

Annie Gao Goodwin, M.D.

  • Pediatric Gastroenterology Physician
  • Webster, TX
National Provider Identifier
1588907166
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
Q8480 Issued in TX
Practice address
250 Blossom St
FL 4
Webster, TX 77598-4204
Phone
(409) 772-3695
Fax
(832) 632-7866
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q8480 TX
Pediatric Gastroenterology Physician 2080P0206X 25680 NH
Pediatric Gastroenterology Physician 2080P0206X Q8480 TX Primary

Addresses

Primary practice location

250 Blossom St
FL 4
Webster, TX 77598-4204

Mailing address

12901 Bruce B Downs Blvd
MDC 41
Tampa, FL 33612-4742

Other practice location 1

12901 Bruce B Downs Blvd
MDC 41
Tampa, FL 33612-4742
Phone (813) 259-8725

Other practice location 2

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5000

Other practice location 3

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200730002685 TX Practitioner - Pediatric Medicine 9638594120 Reassigns benefits to 1 organization
I20240816002748 NH Practitioner - Pediatric Medicine 9638594120 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25680NHMDPediatric Gastroenterology Physician
Q8480TXMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince Aug 19, 2024 Accepting new patients
Utmb Faculty Group Practice Pediatrics CurrentSince Sep 21, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 19, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 19, 2024 Accepting new patients
University of Texas Medical Branch at Galveston PastSince Jun 23, 2024 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

250 Blossom St
Fl 4
Webster, TX 77598
Phone (409) 772-3695

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1588907166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "address_2": "MDC 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST",
            "address_2": "FL 4",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "409-772-3695",
            "fax_number": "832-632-7866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 Bruce B Downs Blvd",
            "address_2": "MDC 41",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124742",
            "country_code": "US",
            "telephone_number": "813-259-8725",
            "fax_number": "813-259-8847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "fax_number": "603-640-1228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hitchcock Way",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031044125",
            "country_code": "US",
            "telephone_number": "603-695-2500",
            "fax_number": "603-640-1228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "ANNIE",
        "middle_name": "GAO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q8480",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NH",
            "license": "25680",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "Q8480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.