Nicole Elise Goodwin, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

250702 Issued in AZ

Practice address

2187 N Vickey St
Flagstaff, AZ 86004-6121

Phone

(928) 527-1899

Fax

(928) 447-5141

NPI assigned

Apr 23, 2021

Last updated

Jun 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guidance Center, Inc.Group PAC ID 0143132076, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.goodwin.p1@direct.tgcaz.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Guidance Center Inc

  dba The Guidance Center, Inc.

  • Community/Behavioral Health Agency
  • Flagstaff, AZ
  • NPI 1679563290
  Medicare reassignment Care Compare group NPD
• Guidance Center Inc

  dba The Guidance Center, Inc.

  • Community/Behavioral Health Agency
  • Williams, AZ
  • NPI 1316014459
  NPD

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1851973382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 N PINE CLIFF DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013269",
            "telephone_number": "928-440-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2187 N VICKEY ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860046121",
            "telephone_number": "928-527-1899",
            "fax_number": "928-447-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2695 E Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860046109",
            "country_code": "US",
            "telephone_number": "928-527-0827",
            "fax_number": "928-447-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "NICOLE",
        "middle_name": "ELISE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "250702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.