Active NPI
Greg Thomas Goodale, D.C.
- Chiropractor
- Schaller, IA
National Provider Identifier
1063738516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 007292
- Practice address
- 204 W. 2ND St
Schaller, IA 51053-0369 - Phone
- (712) 275-4790
- Fax
- (712) 275-4349
- NPI assigned
- Apr 8, 2010
- Last updated
- Apr 19, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 007292 | IA | Primary |
Addresses
Primary practice location
204 W. 2ND St
Schaller, IA 51053-0369
Mailing address
204 W 2ND St.
PO Box 369
Schaller, IA 51053-0369
Phone (712) 275-4790
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IA19158 | Medicaid | IA | |
| IB1758 | Other | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pitts Family & Sports Chiropractic CTRS PC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Harlan, IA
- NPI 1952467631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1063738516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 W 2ND ST.",
"address_2": "PO BOX 369",
"city": "SCHALLER",
"state": "IA",
"postal_code": "510530369",
"telephone_number": "712-275-4790",
"fax_number": "712-275-4349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 W. 2ND ST",
"city": "SCHALLER",
"state": "IA",
"postal_code": "510530369",
"telephone_number": "712-275-4790",
"fax_number": "712-275-4349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODALE",
"first_name": "GREG",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-08",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "007292",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "IA19158",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "IB1758",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Schaller, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.