Jacey E Goddard, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

1766 Issued in ME

Practice address

491 US Route 1
Freeport, ME 04032-7021

Phone

(207) 865-6655

Fax

(207) 865-6653

NPI assigned

May 26, 2006

Last updated

May 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Osteopathic Manipulative MedicineAlso: Family Practice

Education

West Virginia School of Osteopathic Medicine, 2001

Medicare assignment

May accept Medicare assignment

Group practices

Freeport Osteopathic Health PCGroup PAC ID 3577735695, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Rivertree Osteopathic Health PC

  dba Freeport Osteopathic Health

  • Neuromusculoskeletal Medicine & OMM Physician
  • Topsham, ME
  • NPI 1093002438
  Medicare reassignment Care Compare group NPD Authorized official
• Maine Medical Partners

  dba Maine Medical Partners Family Medicine

  • Family Medicine Physician
  • Scarborough, ME
  • NPI 1467477349
  Medicare reassignment NPD
• Mainehealth

  dba MMP Family Medicine

  • Family Medicine Physician
  • Portland, ME
  • NPI 1639194509
  Medicare reassignment NPD
• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  dba Maine Medical Center Neonate Eye

  • Ophthalmology Physician
  • Portland, ME
  • NPI 1730378894
  NPD
• Norumbega Medical Specialists, LTD

  • Health Service Clinic/Center
  • Brewer, ME
  • NPI 1780821140
  NPD (past)
• Reform Physical Therapy, Inc

  • Physical Therapist
  • Yarmouth, ME
  • NPI 1487028775
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1073569216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 US ROUTE 1",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040327021",
            "telephone_number": "207-865-6655",
            "fax_number": "207-865-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 US ROUTE 1",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040327021",
            "telephone_number": "207-865-6655",
            "fax_number": "207-865-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "JACEY",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "1766",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freeport Place
• Ann E Fullagar
• Lowell Ian Gerber, MD
• Daniel S Gibbons, DO
• Hadley Gibson, LMSW-CC
• Meghan Kathleen Gorchoff, LCPC
• Sarah Grant, OT
• Julie M Gray, PA-C
• Nina Sao Haas, DPT
• John Gordon Haldeman, P.T.

• Neuromusculoskeletal Medicine & OMM Physician in Freeport, ME
• Providers in Freeport, ME by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.