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NPI Code Detail

MEDICARE: MS. CATHERINE WALTER GOODYEAR P.A.-C

MEDICARE: MS. CATHERINE WALTER GOODYEAR P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-07310NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2Q00972340OTHERNCRAILROAD MEDICARE
3NA3809AOTHERNCMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
42064JOTHERNCBCBS NC

General Provider Information

NPI Number : 1720013543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHERINE WALTER GOODYEAR P.A.-C
Provider Business Mailing Address
First Line : PO BOX 360
Second Line :
City : SYLVA
State : NC
Zip : 28779-0360
Country : US
Telephone Number : 888-339-6065
Fax Number : 828-538-4441
Provider Business Practice Location Address
First Line : 4740 COMMERCIAL PARK CT
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-9387
Country : US
Telephone Number : 336-245-9521
Fax Number : 855-308-2340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 04/14/2025

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