Active NPI
Tre Goodwin
- Psychiatric/Mental Health Nurse Practitioner
- Albuquerque, NM
National Provider Identifier
1972449734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 89517
- Practice address
- 5203 Juan Tabo Blvd NE Ste 2B
Albuquerque, NM 87111-2691 - Phone
- (346) 323-1847
- NPI assigned
- Apr 24, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 89517 | NM | Primary |
Addresses
Primary practice location
5203 Juan Tabo Blvd NE Ste 2B
Albuquerque, NM 87111-2691
Mailing address
21341 Rising Fawn Rd
Porter, TX 77365-7632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89517 | NM | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1972449734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21341 RISING FAWN RD",
"city": "PORTER",
"state": "TX",
"postal_code": "773657632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5203 JUAN TABO BLVD NE STE 2B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112691",
"telephone_number": "346-323-1847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "TRE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-24",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NM",
"license": "89517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.