Jessica Goodwin, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP016926 Issued in PA

Practice address

1111 Franklin St
Suite 130
Johnstown, PA 15905-4330

Phone

(814) 534-5724

Fax

(814) 536-1786

NPI assigned

Dec 5, 2016

Sex

Female

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

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• DLP Conemaugh Physician Practices LLC

  • Family Medicine Physician
  • Cresson, PA
  • NPI 1932515905
  Medicare reassignment NPD
• DLP Conemaugh Physician Practices LLC

  • Internal Medicine Physician
  • Johnstown, PA
  • NPI 1205242609

  Nurse Practitioner

  NPD
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1639613003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-410-8300",
            "fax_number": "814-410-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN ST",
            "address_2": "SUITE 130",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-534-5724",
            "fax_number": "814-536-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Samaritan Medical Center of Johnstown
• Cami Good, MD
• Susan Brown Good, AU.D.
• Richard Paul Goodrich Jr., D.O.
• Goodwill of the Southern Alleghenies
• Kimberly Marie Gorman, DNP, AG-ACNP-BC,
• Amanda Ann Gorzelsky, PHARM D
• Samantha Amanda Gould, PA-C
• Colleen Grajeda, COTA/L
• Erin Gramling

• Nurse Practitioner in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.