Individual provider Active NPI

Harold Goodrum Jr.

  • Hand Occupational Therapist
  • Morgantown, WV
National Provider Identifier
1194273185
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
2507 Issued in WV
Practice address
943 Maple Dr
Morgantown, WV 26505-2812
Phone
(304) 599-2515
Fax
(304) 285-3738
NPI assigned
Sep 19, 2016
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2554 GA
Hand Occupational Therapist 225XH1200X 2507 WV Primary

Addresses

Primary practice location

943 Maple Dr
Morgantown, WV 26505-2812

Mailing address

943 Maple Dr
Morgantown, WV 26505-2812
Phone (304) 599-2515

Other identifiers 1

IdentifierTypeStateIssuer
002554OtherGAOT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407000381 WV Practitioner - Occupational Therapist in Private Practice 1052385887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

943 Maple Dr
Morgantown, WV 26505-2812
Phone (304) 599-2515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2507WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Morgantown Physical Therapy Associates, Inc. CurrentSince Mar 24, 2025 Accepting new patients
Morgantown Physical Therapy Associates, Inc. CurrentSince Mar 24, 2025 Accepting new patients
Decatur Hand Therapy Specialists Limited Partnership Past Accepting new patients

Locations

103 Professional Arts Plaza Dr
Buckhannon, WV 26201
Phone (304) 427-0181

943 Maple Dr
Morgantown, WV 26505
Phone (304) 599-2515

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1194273185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 MAPLE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052812",
            "telephone_number": "304-599-2515",
            "fax_number": "304-285-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 MAPLE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052812",
            "telephone_number": "304-599-2515",
            "fax_number": "304-285-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRUM",
        "first_name": "HAROLD",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-19",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "2554",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WV",
            "license": "2507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "002554",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.