Individual provider Active NPI

Andrew Robert Goodrich, FPMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clive, IA
National Provider Identifier
1881267706
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G164620 Issued in IA
Practice address
1450 NW 114TH St
Clive, IA 50325-7039
Phone
(844) 680-0504
NPI assigned
Jul 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G164620 IA Primary

Addresses

Primary practice location

1450 NW 114TH St
Clive, IA 50325-7039

Mailing address

8191 Birchwood CT Unit a
Johnston, IA 50131-2931
Phone (515) 217-4847

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220112002753 IA Practitioner - Nurse Practitioner 4385036888 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs Midwest Behavioral Health LLC CurrentSince Oct 14, 2021 Accepting new patients
Mohr Altitude, LLC PastSince Jul 1, 2024 Accepting new patients

Locations

1450 NW 114th St
Clive, IA 50325
Phone (515) 553-6200

Organizations & group practices 3

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1881267706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8191 BIRCHWOOD CT UNIT A",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312931",
            "telephone_number": "515-217-4847",
            "fax_number": "515-257-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 NW 114TH ST",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257039",
            "telephone_number": "844-680-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "ANDREW",
        "middle_name": "ROBERT",
        "credential": "FPMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G164620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.