Individual provider Active NPI

Eric Wayne Goodman, D.C.

  • Chiropractor
  • Cornelius, NC
National Provider Identifier
1124385844
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4363 Issued in NC
Practice address
18047 W Catawba Ave Ste a
Cornelius, NC 28031-5663
Phone
(704) 956-1107
Fax
(704) 987-3991
NPI assigned
Apr 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4363 NC Primary

Addresses

Primary practice location

18047 W Catawba Ave Ste a
Cornelius, NC 28031-5663

Mailing address

4805 Park Rd
Ste 225
Charlotte, NC 28209-3809
Phone (704) 956-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000473 NC Practitioner - Chiropractic 6800037060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
De Health Partners PCGroup PAC ID 7618262759, 4 clinicians

Practice addresses (Care Compare)

4601 Park Rd
Suite 100
Charlotte, NC 28209-2296
Phone (704) 527-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4363NCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Goodman Chiropractic, PC Chiropractor CurrentSince May 3, 2013 Accepting new patients
De Health Partners PC Chiropractor CurrentSince Jul 1, 2016 Accepting new patients
Lake Norman Health and Wellness, PA Chiropractor PastSince May 3, 2013 Accepting new patients

Locations

4805 Park Rd
Ste 225
Charlotte, NC 28209
Phone (704) 527-7246

4601 Park Rd
Ste 100
Charlotte, NC 28209
Phone (704) 527-7246

19607 W Catawba Ave
Ste 103
Cornelius, NC 28031
Phone (704) 956-1107

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1124385844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 PARK RD",
            "address_2": "STE 225",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093809",
            "telephone_number": "704-956-1107",
            "fax_number": "704-987-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18047 W CATAWBA AVE STE A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315663",
            "telephone_number": "704-956-1107",
            "fax_number": "704-987-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ERIC",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.