Goodwin Medical Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24747 Issued in AL

Legal business name

GOODWIN MEDICAL CLINIC LLC

Practice address

431 S 3Rd St
Gadsden, AL 35901-5210

Phone

(256) 547-0433

Fax

(256) 547-0460

NPI assigned

Oct 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Dalton Goodwin, M.D.

Title

Owner/ Sole Member of LLC

Phone

(256) 547-0433

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1841662020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 S 3RD ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015210",
            "telephone_number": "256-547-0433",
            "fax_number": "256-547-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S 3RD ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015210",
            "telephone_number": "256-547-0433",
            "fax_number": "256-547-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWIN MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "DALTON",
        "authorized_official_title_or_position": "OWNER/ SOLE MEMBER OF LLC",
        "authorized_official_telephone_number": "256-547-0433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "24747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "10270G2201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD LOCATION ID NUMBER",
            "identifier": "511-69544",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Herandenny Giraldo, MD
• Gmsphc Partners LLC
• George Scott Godfey, R.PH.
• Ashleigh Patrice Goggins, LPC-S;NCC
• Kristan Goodman
• Jeremy Dalton Goodwin, M.D.
• Gordon R Isbell, III, DMD, PA
• Amy M Gorecki Kelley, CRNP
• Brooke Leann Gorham, D.P.M.
• Billy Barrett Gravitt, DMD

• Family Medicine Physician in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.