Active NPI
Jeffery D Goodwin, DPH
- Pharmacist
- Winchester, TN
National Provider Identifier
1750879680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6617
- Practice address
- 2675 Decherd Blvd
Winchester, TN 37398-1166 - Phone
- (931) 967-0046
- NPI assigned
- Apr 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6617 | TN | Primary |
Addresses
Primary practice location
2675 Decherd Blvd
Winchester, TN 37398-1166
Mailing address
400 Riva Lake Rd
Winchester, TN 37398-4468
Phone (931) 580-5692
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6617 | Other | TN | TENNESSEE BOARD OF PHARMACY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6617 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1750879680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 RIVA LAKE RD",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373984468",
"telephone_number": "931-580-5692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2675 DECHERD BLVD",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373981166",
"telephone_number": "931-967-0046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "JEFFERY",
"middle_name": "D",
"credential": "DPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-26",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "6617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNESSEE BOARD OF PHARMACY",
"identifier": "6617",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.