Jennifer Goddard, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

63630 Issued in AZ

Practice address

1050 Gail Gardner Way Ste 100
Prescott, AZ 86305-1631

Phone

(928) 777-0700

Fax

(928) 445-4464

NPI assigned

Jul 10, 2009

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Family Practice

Education

University of South Carolina School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Prescott, AZ, CCN 037139
• Nurses Network by Quality Home Health Care Home health agency, Prescott Valley, AZ, CCN 037154
• Mountain Valley Home for Health Home health agency, Prescott Valley, AZ, CCN 037456
• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Yavapai Regional Medical Center Physician Care LLC

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1255582003
  Medicare reassignment Care Compare group NPD
• Yavapai Regional Medical Center Physician Care LLC

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1528394830
  NPD
• Prescott Gastroenterology

  • Gastroenterology Physician
  • Prescott, AZ
  • NPI 1720110984
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerwell Certified Healthcare Corp

  • Home Health Agency
  • Prescott, AZ
  • NPI 1437158821
  Care Compare affiliation
• Mountain Valley Regional Rehabilitation Hospital Inc

  • Home Health Agency
  • Prescott Valley, AZ
  • NPI 1174904130
  Care Compare affiliation
• Nurses Network Incorporated

  • Home Health Agency
  • Prescott Valley, AZ
  • NPI 1215990486
  Care Compare affiliation
• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1124257282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 GAIL GARDNER WAY STE 100",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051631",
            "telephone_number": "928-777-0700",
            "fax_number": "928-445-4464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Gail Gardner Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863051640",
            "country_code": "US",
            "telephone_number": "928-717-5232",
            "fax_number": "928-717-5238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32040",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "63630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094505",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320405",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher A Glade, LMSW
• Gladhart Family Medicine
• Karen Ruth Gladhart
• Judith Kay Glann, ACNP-BC
• Kenneth Glass, D.D.S.
• Susan Elizabeth Godman, N.M.D.
• Cacie Lee Goetz-Campos, MSN, FNP-C
• Edward Gogek, MD
• Joseph H Goldberger, MD
• Golden Ratio Health PLLC

• Family Medicine Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.