Shantivia Boneparte Goodwin

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

268305 Issued in NC

Practice address

2020 Ashcraft Ave
Monroe, NC 28110-3720

Phone

(704) 292-7152

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• MH Health Care Services, PC

  • Occupational Medicine Clinic/Center
  • Richburg, SC
  • NPI 1285197699
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1740892983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 ASHCRAFT AVE",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103720",
            "telephone_number": "704-292-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 ASHCRAFT AVE",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103720",
            "telephone_number": "704-292-7152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4374 Lancaster Hwy",
            "address_purpose": "LOCATION",
            "city": "Richburg",
            "state": "SC",
            "postal_code": "297299060",
            "country_code": "US",
            "telephone_number": "803-789-4381",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "SHANTIVIA",
        "middle_name": "BONEPARTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NC",
            "license": "268305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Gnatyuk, RPH
• Godel & Associates IV PLLC
• Stefanie Irene Goldman, MSW, LCSW
• Catherine Gomez Mendez, LCSWA
• Alexis Gonzalez
• Jessica Gordon, OTR/L
• Timothy Gosnell, PT, DPT
• Jennifer Gottlieb, PT
• Magdalena Grabowska
• Graceful Haven

• Emergency Registered Nurse in Monroe, NC
• Providers in Monroe, NC by specialty
• Emergency Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.