| William Goodwin, ARNP | |
|
5053 Main St, Manchester Center, VT 05255-9771 | |
| (802) 293-2929 | |
| (802) 419-8311 |
| Full Name | William Goodwin |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 5053 Main St, Manchester Center, Vermont |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356770630 | NPI | - | NPPES |
| 04087821 | Medicaid | NY | |
| 1024223 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 101-0107976 (Vermont) | Primary |
| 163W00000X | Registered Nurse | ARNP9309446 (Florida) | Secondary |
| Entity Name | Forensic Consultation & Counseling Service |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083997563 PECOS PAC ID: 2668865205 Enrollment ID: O20220203001373 |
| Mailing Address | Practice Location Address |
|---|---|
| William Goodwin, ARNP 704 Staples Rd, Danby, VT 05739-9341 Ph: (802) 293-2929 | William Goodwin, ARNP 5053 Main St, Manchester Center, VT 05255-9771 Ph: (802) 293-2929 |
Lia B Braico, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5957 Main St, Manchester Center, VT 05255 Phone: 802-362-4440 | |
Morgan Ray Bazyk, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 34 Bonnet St, Manchester Center, VT 05255 Phone: 802-768-1718 | |
Mary Jaeger Stacy, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5957 Main St, Northshire Medical Center, Manchester Center, VT 05255 Phone: 802-362-4440 Fax: 802-362-7146 |