Individual provider Active NPI

Brenda Lee Goodner

  • Nurse Practitioner
  • Fort Dodge, IA
National Provider Identifier
1679331219
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A179734 Issued in IA
Practice address
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Phone
(515) 573-3101
NPI assigned
Mar 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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 125895 IA
Nurse Practitioner 363L00000X A179734 IA Primary

Addresses

Primary practice location

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Mailing address

8921 Twin Lakes Rd
Manson, IA 50563-7012
Phone (515) 570-0859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240807003217 IA Practitioner - Nurse Practitioner 6709323728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grinnell Regional Medical CenterGroup PAC ID 0446153662, 98 clinicians

Practice addresses (Care Compare)

202 4TH Ave
FL 2
Grinnell, IA 50112-1898
Phone (641) 236-2925

210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-7511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125895IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center CurrentSince Sep 23, 2024 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Grinnell Regional Medical Center Nurse Practitioner CurrentSince Jun 15, 2025 Accepting new patients

Locations

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

210 4th Ave
Grinnell, IA 50112
Phone (641) 236-2055

Interoperability endpoints

  • Direct secure messaging: bgoodner2498@direct.unitypoint.org

Organizations & group practices 3

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 1

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": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1679331219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 TWIN LAKES RD",
            "city": "MANSON",
            "state": "IA",
            "postal_code": "505637012",
            "telephone_number": "515-570-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-573-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODNER",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "125895",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A179734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.