Individual provider Active NPI

Jordan Elyse Goodin, FNP

  • Family Nurse Practitioner
  • Mexico, MO
National Provider Identifier
1639949928
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024005871 Issued in MO
Practice address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone
(573) 582-1234
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2018023543 MO
Family Nurse Practitioner 363LF0000X 2024005871 MO Primary

Addresses

Primary practice location

340 Kelley Pkwy
Mexico, MO 65265-3811

Mailing address

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Other practice location 1

2625 Fairway Dr
Fulton, MO 65251-4035
Phone (573) 582-1234

Other practice location 2

1225 Aguilar Dr
Montgomery City, MO 63361-2723
Phone (573) 358-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20240305001898 MO Practitioner - Nurse Practitioner 0749625382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018023543MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
East Central Missouri Behavioral Health Services, Inc CurrentSince Feb 14, 2024 Accepting new patients
East Central Missouri Behavioral Health Services, Inc CurrentSince Feb 14, 2024 Accepting new patients

Locations

340 Kelley Pkwy
Mexico, MO 65265
Phone 5735821234 ext. 3017

Interoperability endpoints

  • Direct secure messaging: jordan.goodin.p1@direct.arthurcenter.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1639949928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MO",
            "postal_code": "652514035",
            "country_code": "US",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 Aguilar Dr",
            "address_purpose": "LOCATION",
            "city": "Montgomery City",
            "state": "MO",
            "postal_code": "633612723",
            "country_code": "US",
            "telephone_number": "573-358-1234",
            "fax_number": "573-582-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "JORDAN",
        "middle_name": "ELYSE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2018023543",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024005871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mexico, MO

Sources for this page

Verify at the official NPI Registry.