Jeremy T Goodwin, MD
Individual provider Active NPI Internal Medicine Physician · Forsyth, GA
NPI 1639384407 · NPPES record last updated Sep 16, 2013
Key facts
- NPI
- 1639384407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 059416 (GA)
- Practice address
- 97 Martin Luther King Jr Dr
Forsyth, GA 31029-1648 - Phone
- (478) 994-1010
- Fax
- (478) 994-1080
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Mercer University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Internal Medicine Associates of Middle Georgia, P.C.
Practice addresses (Care Compare)
97 Martin Luther King Jr Dr
Forsyth, GA 31029-1648
Phone (478) 994-1010
Hospital & facility affiliations
- Amedisys Home Health of Macon
- Enhabit Home Health
- Atrium Health Navicent at Home
- Pruitthealth Hospice-Macon
- Heartland Hospice- Macon
- Monroe County Hospital
- Atrium Health Navicent the Medical Center
- Coliseum Medical Centers, LLC, Dba
- Monroe County Hospital
- Pruitthealth - Monroe
- Pruitthealth - Forsyth
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070723000752 | GA | Practitioner - Family Practice |
3779684527 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Internal Medicine Associates of Middle Georgia, P.C. | Internal Medicine | Current |
Accepting new patients |
| Pruitthealth - Monroe, LLC | Past | Accepting new patients | |
| Pruitthealth - Forsyth, LLC | Past | Accepting new patients | |
| The Hospital Authority of Monroe County, Georgia | Past | Accepting new patients |
Locations
97 Martin Luther King Jr Dr
#D
Forsyth, GA 31029
Phone (478) 994-1010
88 Martin Luther King Jr Dr
#D
Forsyth, GA 31029
Phone (419) 994-2521
88 Martin Luther King Jr Dr
Forsyth, GA 31029
Phone (419) 994-2521
97 Martin Luther King Jr Dr
Forsyth, GA 31029
Phone (478) 957-9139
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 059416 | GA | Yes |
Addresses
Primary practice location
97 Martin Luther King Jr Dr
Forsyth, GA 31029-1648
Mailing address
97 Martin Luther King Jr Dr
Forsyth, GA 31029-1648
Phone (478) 994-1010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 841584607A | Medicaid | GA |
Other providers in Forsyth, GA
- Joel Robert Fountain Jr.
- Georgia Braces Forsyth LLC
- Georgia CVS Pharmacy LLC
- Shannon Susanne Gonzalez
- Elizabeth Goodwin
- Shannon Terrell Gordon
- Jessica P Graham
- Jennifer Harrison Grogan
- Clark Hall
- Elizabeth Hardy
All providers in Forsyth, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.