Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan Owen Goodwin

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1649818998

Jordan Owen Goodwin is a Physician Assistant in Greenville, South Carolina. Qualified in 2019, 7 years ago. Practices with Prisma Health University Medical Group, a 2,446-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
7
Licensed in
SC
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

890 W Faris Rd Ste 550
Greenville, SC 29605-4286
Phone: (864) 455-6800
Fax: (864) 455-6825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8645 Summit Peak Way Apt 402, Ooltewah, TN 37363-3149 — (864) 363-3414

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4843 (SC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1649818998
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 17, 2019
Last updated in NPPESMay 17, 2023
Certification dateMay 17, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Prisma Health University Medical Group — 2446 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Greenville