Jinelle Marie Goodwin, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

53398 Issued in NM

Practice address

85 West Hwy 22
Santo Domingo Pueblo, NM 87052

Phone

(505) 465-3060

NPI assigned

May 6, 2022

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

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jinelle.scully.p1@direct.kp-hc.nextgenshare.com

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.

• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)
• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888
  NPD (past)

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1861138596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870520340",
            "telephone_number": "505-465-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WEST HWY 22",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "87052",
            "telephone_number": "505-465-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JINELLE",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NM",
            "license": "53398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avadana Garcia
• Christina J Garcia
• Kandyce Garcia
• Mercell A Garcia, CHW
• Gaetane Gonzales
• McCarson Leigh Jones, LMSW
• Kewa Pueblo Health Corporation
• Kewa Pueblo Health Corporation
• Denise Kiklis
• Terrance Kusserow, RNWCC

• Community Health Registered Nurse in Santo Domingo Pueblo, NM
• Providers in Santo Domingo Pueblo, NM by specialty
• Community Health Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.