Laura Sue Goodwin, RN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

608881 Issued in TX

Practice address

4715 Viewridge Ave
Ste 230
San Diego, CA 92123-1658

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Merit-based Incentive Payment System (MIPS)

Final score

79.54 of 100Reported as group

Quality

72.94

Improvement activities

40

Cost

48.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Med Management Associates

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1508233040

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1689615197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 CRAWFORD CT",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281010",
            "telephone_number": "469-293-5296",
            "fax_number": "469-293-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 VIEWRIDGE AVE",
            "address_2": "STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231658",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "LAURA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "RN, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "608881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175547203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175547202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N9636",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goodwill Healthcare Services Inc.
• Goodwill Hospice Care Inc
• Vanessa Goodwill, MD
• Jane D. Goodwin, O.D.
• Kim M Goodwin, M.D.
• Lorraine Goodwin, FNP
• Patrick Goodwin, NNP
• Rachel Katherine Goodwin, CNM/NP
• Trent Gookin, DDS
• Ashten Goolsby, LAC, DACM

• All providers in San Diego, CA
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.