Active NPI
Alexandra Goodman
- Nurse Practitioner
- Fort Mill, SC
National Provider Identifier
1619773652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 31182
- Practice address
- 1808 Second Baxter Xing Ste 108
Fort Mill, SC 29708-6437 - Phone
- (803) 802-2225
- NPI assigned
- Feb 20, 2025
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 31182 | SC | Primary |
Addresses
Primary practice location
1808 Second Baxter Xing Ste 108
Fort Mill, SC 29708-6437
Mailing address
1808 Second Baxter Xing Ste 108
Fort Mill, SC 29708-6437
Phone (803) 802-2225
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787097600000",
"number": "1619773652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 SECOND BAXTER XING STE 108",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297086437",
"telephone_number": "803-802-2225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 SECOND BAXTER XING STE 108",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297086437",
"telephone_number": "803-802-2225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-20",
"last_updated": "2026-08-19",
"certification_date": "2026-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "31182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.