Individual provider Active NPI

Nancy J. Goodwin, D.O.

  • Internal Medicine Physician
  • Naples, FL
National Provider Identifier
1861679227
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS11292 Issued in FL
Practice address
12260 Tamiami TRL E Ste 102
Naples, FL 34113
Phone
(954) 274-9332
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X OS11292 FL
Internal Medicine Physician 207R00000X OS11292 FL Primary

Addresses

Primary practice location

12260 Tamiami TRL E Ste 102
Naples, FL 34113

Mailing address

12260 Tamiami TRL E Ste 102
Naples, FL 34113-7937
Phone (954) 274-9332

Other identifiers 1

IdentifierTypeStateIssuer
OS11292OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20120104000855 FL Practitioner - Emergency MedicinePractitioner - Internal Medicine 6103902242 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Florida Emergency Management LLC CurrentSince Sep 14, 2015 Accepting new patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Miracle Visiting Professionals, Inc. Internal Medicine Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients
Marshland Emergency Physicians, LLC Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

40 S Heathwood Dr
Marco Island, FL 34145
Phone (239) 393-4079

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJFEBD/Endpoint/BJFEBD

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1861679227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12260 TAMIAMI TRL E STE 102",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341137937",
            "telephone_number": "954-274-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12260 TAMIAMI TRL E STE 102",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34113",
            "telephone_number": "954-274-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "NANCY",
        "middle_name": "J.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "OS11292",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS11292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS11292",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.