JOHNNIE BRADLEY-GOODMAN (NPI# 1306322656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306322656 |
| Entity Type | Individual |
| Full Name | JOHNNIE BRADLEY-GOODMAN |
| Credential | ARNP |
| Practice Address |
1833 Boulevard Jacksonville FL 32206 |
| Mailing Address |
Po Box 44008 Jacksonville FL 32231-4008 |
| Practice Telephone | 9043831040 |
| Practice Fax Number | 9042448952 |
| Mailing Telephone | 9043831040 |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-11-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9215272 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3040 Bluejack Ct, Orange Park, FL 32073 | 9045535894 |
| Street Address |
1833 BOULEVARD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740289180 | Siddiqa K Khan | Family Medicine | 1833 Boulevard, Va Outpatient Clinic, Jacksonville, FL 32206-4382 | 2005-07-19 |
| 1538541321 | Daniel Kwamena Korsah | Nurse Practitioner | 1833 Boulevard, 5th Floor, Jacksonville, FL 32206-4382 | 2015-06-29 |
| 1902296080 | Byron Melvin Johnson | Nurse Practitioner | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2015-01-28 |
| 1932448321 | Martha Michelle Hicks | Nurse Practitioner | 1833 Boulevard, Ufjp - Chfm - Shands Total Care Clinic, Jacksonville, FL 32206-4382 | 2013-02-06 |
| 1447524012 | Tracie Claudice Rutledge | Nurse Practitioner | 1833 Boulevard, Ufjax - Total Care Clinic, Jacksonville, FL 32206-4382 | 2012-02-29 |
| 1649543232 | Monica Lynn Monahan | Psychologist | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2012-02-14 |
| 1932436169 | Lionel Staplefoote | Case Manager/Care Coordinator | 1833 Boulevard, Suite 500, Jacksonville, FL 32206-4382 | 2009-11-09 |
| 1770810251 | Christina Adkins Shotwell | Psychologist | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2009-11-04 |
| 1245564327 | Maria Antoun | Pharmacist | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2009-09-23 |
| 1932330016 | Denise A Daniels | Counselor | 1833 Boulevard, Suite 500, Jacksonville, FL 32206-4382 | 2009-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790275543 | Marvin Victor Sindel IIi | Nurse Practitioner | 1241 E 8th St, Jacksonville, FL 32206 | 2018-05-17 |
| 1982126553 | Marcia Camille Holloway | In Home Supportive Care | 647 East 31th Street, Jacksonville, FL 32206 | 2017-07-14 |
| 1407302656 | Tahnita Fleming | Day Training, Developmentally Disabled Services | 1309 Van Buren Street, Jacksonville, FL 32206 | 2016-08-28 |
| 1912202136 | Bishop Home Care, Inc | Clinic/Center | 1627 E 8th Street, Jacksonville, FL 32206 | 2011-01-19 |
| 1407183965 | Richard Adam Crosby | Chiropractor | 4211 North Pearl St., Jacksonville, FL 32206 | 2009-11-04 |
| 1346494903 | Delvenia Renee Mitchell | Specialist | 4515 N Pearl St Apt 2, Jacksonville, FL 32206 | 2008-11-10 |
| 1962662775 | Curtis Michael Bryant | Radiology | 2015 Jefferson Street, University of Florida Proton Institute, Jacksonville, FL 32206 | 2008-06-15 |
| 1932253879 | Gale Marie Cohen-weiss | Social Worker | Veterans Health System, Jacksonville Outpatient Clinic, 1833 Boulevard, Jacksonville, FL 32206 | 2007-01-22 |
| 1396817557 | Bella Caimol Ejercito | Internal Medicine | 4608 Norwood Ave, Jacksonville, FL 32206 | 2006-11-14 |
| 1962584433 | Jessica Ivette Warthen | Pharmacist | 1833 Boluevard, Department of Veterans Affairs; Mental Health Clinic, Jacksonville, FL 32206 | 2006-10-20 |
| Find all providers in zip 32206 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1497368757 | Arthur C Ricker Jr. | Nurse Practitioner | 501 E Bay St Fl 32202, Jacksonville, FL 32202-2927 | 2020-08-26 |
| 1851851554 | Veronica H Bartley | Nurse Practitioner | 15319 Spotted Stallion Trl, Jacksonville, FL 32234-2397 | 2019-03-20 |
| 1366947475 | Tikilia Denise Scott | Nurse Practitioner | 3599 University Blvd S Ste 400, Jacksonville, FL 32216-4232 | 2018-03-29 |
| 1376065417 | Geraldine M Obi | Nurse Practitioner | 3599 University Blvd S Ste 1600, Jacksonville, FL 32216-7441 | 2017-07-11 |
| 1881130060 | Yaazmiyn White | Nurse Practitioner | 8868 Merseyside Ave, Jacksonville, FL 32219-4355 | 2017-01-12 |
| 1821545872 | Anmarie Chandler | Nurse Practitioner | 320 Branscomb Dr Sw Ste A, Jacksonville, AL 36265-3102 | 2016-09-07 |
| 1538523402 | Julia Peters Paul | Nurse Practitioner | 10898 Tarin Dr, Jacksonville, FL 32218-4808 | 2016-04-07 |
| 1487035465 | Aggie Kalyn Hunt | Nurse Practitioner | 237 Old White Street, Suite 1, Jacksonville, NC 28546-6351 | 2015-06-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32206 |
Please comment or provide details below to improve the information on JOHNNIE BRADLEY-GOODMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.