Donnal Blake Goodwin, COTA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

125127 Issued in TX

Practice address

116 McCardell LN
Livingston, TX 77351-3347

Phone

(936) 239-3308

NPI assigned

Dec 17, 2018

Sex

Male

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

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Synergy Care Southeast, LLC

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1427466614

  Occupational Therapist, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1730650615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MCCARDELL LN",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773513347",
            "telephone_number": "936-239-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MCCARDELL LN",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773513347",
            "telephone_number": "936-239-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "DONNAL",
        "middle_name": "BLAKE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "125127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TBOTE CERTIFICATION",
            "identifier": "209855",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT LICENSE",
            "identifier": "221830",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVES LICENSE",
            "identifier": "19091795",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George L. Deloach, D.O., PA
• Gerald Ratinov MD Care P a
• Alison Glass, OTD
• Christina Marie Gonzalez, LPC
• Good Shepherd Assistant Living
• Thomas Reagan Graffagnino, FNP-C
• Roxanne Green, LCDC
• Shaniqua Green
• Paul Francis Griffin, MSPT
• Anna Grimmett

• Occupational Therapist in Livingston, TX
• Providers in Livingston, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.