NPIMap

Individual provider Active NPI

Amy M Goodin, PA-C

  • Physician Assistant
  • Meridian, MS
National Provider Identifier
1952569261
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00109 Issued in MS
Practice address
1800 12TH St
Meridian, MS 39301-4158
Phone
(601) 703-9639
Fax
(601) 703-3273
NPI assigned
May 23, 2008
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00109 MS Primary

Addresses

Primary practice location

1800 12TH St
Meridian, MS 39301-4158

Mailing address

PO Box 5183
Meridian, MS 39302-5183
Phone (601) 703-9506

Other practice location 1

2111 14th St
Meridian, MS 39301-4041
Phone (601) 693-3834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000964 MS Practitioner - Physician Assistant 2466647904 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Physician Alliance IncGroup PAC ID 3274727318, 69 clinicians
Bear Creek Emergency Group LLCGroup PAC ID 8820587629, 33 clinicians

Practice addresses (Care Compare)

1102 Constitution Ave
Meridian, MS 39301-4001
Phone (601) 553-5000

1600 22ND Ave
Meridian, MS 39301-3223
Phone (601) 483-5322

2124 14TH St
Meridian, MS 39301-4040
Phone (601) 553-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.62 of 100Reported as group
Quality
39.81
Improvement activities
40
Cost
80.88

Merit-based Incentive Payment System (MIPS)

Final score
58.75 of 100Reported as group
Quality
26.99
Improvement activities
40
Cost
71.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00109MSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Physician Alliance, Inc CurrentSince Aug 1, 2024 Accepting new patients
Bear Creek Emergency Group LLC Physician Assistant CurrentSince Nov 1, 2025 Accepting new patients
Anderson Physician Alliance, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Urology Clinic of Meridian, P.a. Current Accepting new patients

Locations

1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322

2111 14th St
Meridian, MS 39301
Phone (601) 693-3834

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1952569261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5183",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025183",
            "telephone_number": "601-703-9506",
            "fax_number": "601-703-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-9639",
            "fax_number": "601-703-3273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2111 14th St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014041",
            "country_code": "US",
            "telephone_number": "601-693-3834",
            "fax_number": "601-693-8239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.