KELLY RAE GOODWIN (APRN) – Primary Care Nurse Practitioner, NPI 1841761798

Primary Care Nurse Practitioner

KELLY RAE GOODWIN (APRN) is a healthcare provider. based in Port orange, Florida. specializing in Primary Care Nurse Practitioner. They hold the professional credentials APRN. They hold a License No. AG12180060 (FL). The NPI Number for KELLY RAE GOODWIN (APRN) is 1841761798

Main info

Female

Sole Proprietor

8 Years Of Experience

Accepts Medicare Assignment

Name

KELLY RAE GOODWIN (APRN)

NPI

1841761798

Phone

(405) 568-9165

Address

636 HAMLET DR

Enumeration Date

17 December 2018

Last Update Date

29 March 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3866726243

Graduation Year

2018 (8 years ago)

PAC ID

9133541709

Group Practice PAC ID

4789728320

Professional Enrollment ID

I20200629000254

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience38

Completeness75

Years active:7State licenses:1Digital endpointsOther names

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Provider Addresses for KELLY RAE GOODWIN (APRN)

636, Hamlet Drive, Port Orange, Volusia County, Florida, 32127, United States
PORT ORANGE, FL 321275986
Phone: (405) 568-9165
Type: Mailing
14543 LARRY ST
CHOCTAW, OK 730208569
Phone: (405) 568-9165
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4789728320View full group profile

Name	Specialty	State
MR. MICHAEL J RODRIGUEZ (D.C.)	-	FL
RAMIN D BONNET (DO)	-	FL

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Frequently asked questions

How is KELLY RAE GOODWIN (APRN) identified in CMS data?

CMS-hosted NPPES data lists KELLY RAE GOODWIN (APRN) with NPI 1841761798.

Is KELLY RAE GOODWIN (APRN) listed as active for patients and plans?

The listing shows KELLY RAE GOODWIN (APRN) as active in the NPI system.

What is KELLY RAE GOODWIN (APRN)'s primary classification?

Primary Care Nurse Practitioner is the headline specialty for KELLY RAE GOODWIN (APRN) here. Clinical services aligned with this taxonomy classification.

Where should I expect KELLY RAE GOODWIN (APRN) on a map?

Expect Port Orange, Florida as a primary anchor for KELLY RAE GOODWIN (APRN) unless the record lists multiple sites.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.