Charles Goodwin, M.D., PH.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

10093959-1205 Issued in UT

Practice address

30 N 1900 E
Room 4C104
Salt Lake City, UT 84132-0002

Phone

(801) 581-7606

NPI assigned

May 1, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Indiana University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Up Health System Portage Hospital, Hancock, MI, CCN 230108
• Baraga County Memorial Hospital Hospital, L' Anse, MI, CCN 231307
• Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054
• Aspirus Keweenaw Hospital and Clinics Hospital, Laurium, MI, CCN 231319

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684
  Medicare reassignment Care Compare group NPD
• Portage Physician Practices Inc

  • Rural Health Clinic/Center
  • Calumet, MI
  • NPI 1164106910
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aspirus Keweenaw

  • Rural Health Clinic/Center
  • Ontonagon, MI
  • NPI 1023161932

  Hospital

  Care Compare affiliation
• Aspirus Keweenaw

  • Pharmacy
  • Ontonagon, MI
  • NPI 1104516376

  Hospital

  Care Compare affiliation
• Aspirus Keweenaw

  • Critical Access Hospital
  • Laurium, MI
  • NPI 1326115569
  Care Compare affiliation
• Baraga County Memorial Hospital

  • Critical Access Hospital
  • Lanse, MI
  • NPI 1558479824
  Care Compare affiliation
• DLP Marquette General Hospital LLC

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  Care Compare affiliation
• Portage Hospital LLC

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Care Compare affiliation

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1831576529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 500 S APT 408",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113360",
            "telephone_number": "312-933-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "address_2": "ROOM 4C104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "CHARLES",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-01",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "10093959-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alecia M Goodrich
• Bruce R Goodrich, RPH
• Brandon Goodsell
• Kelli Goodson
• Ashley S. Goodwin, MD
• Jamie Goodwin
• Jennifer Lou Goodwin
• Kasinda Goodwin, MD
• Stephanie M Goold
• Rachel Press Goossen, MD

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.