Mary Goodwin

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

319563 Issued in TX

Practice address

1 Freedom Way
Augusta, GA 30904-6258

Phone

(321) 356-7689

NPI assigned

Jul 9, 2019

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

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1750933800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 DERBY LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133835",
            "telephone_number": "321-356-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "321-356-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "319563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiiu Tomika Goode
• Kristin Heller Goodell, DDS
• Memory Kate Goodin, OTR/L
• Rachel Glore Gooding, PA-C
• Cambre Goodlett, PHARMD
• Richard H. Goodwin Jr., M.D.
• Mary Jo Goolsby, NP
• Keerthana Gopichandran
• Gordon Highway Dental Group, LLC (Augusta Smiles Youth Dentistry)
• Chawnette Washington Gordon, CLC

• Licensed Practical Nurse in Augusta, GA
• Providers in Augusta, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.