Individual provider Active NPI

Suzanne Goodwin

  • Licensed Practical Nurse
  • Heber Springs, AR
National Provider Identifier
1720839152
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L020042 Issued in AR
Practice address
74 Cleburne Park Rd
Heber Springs, AR 72543-9106
Phone
(501) 362-0943
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L020042 AR Primary

Addresses

Primary practice location

74 Cleburne Park Rd
Heber Springs, AR 72543-9106

Mailing address

74 Cleburne Park Rd
Heber Springs, AR 72543-9106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L020042ARMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community School of Cleburne County PastSince Apr 9, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1720839152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 CLEBURNE PARK RD",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725439106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 CLEBURNE PARK RD",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725439106",
            "telephone_number": "501-362-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "L020042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.