Adam Anthony Goodwin, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

305514 Issued in CA

Practice address

3110 Wagner Heights Rd
Stockton, CA 95209-4848

Phone

(209) 956-3444

NPI assigned

Apr 15, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1619721917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7768 LIALANA WAY",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956105023",
            "telephone_number": "916-225-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 WAGNER HEIGHTS RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094848",
            "telephone_number": "209-956-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "ADAM",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Samaritan Care Provider LLC (Four Seasons in Paradise)
• Good Samaritan Care Provider LLC (Four Seasons Care Center- Lodi)
• Good Samaritan Carechoice & Compliance Group LLC (A Good Samaritan Home- Barbados)
• Brell Moneece Goodlow
• Deja Makiya Goodlow
• Candice Goodwin
• Eddie Goodwin III
• Ikesha Goodwin
• James Goodwin
• Kevin Goodwin Sr., M.A., APCC, PPS

• Physical Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.