Individual provider Active NPI

Jennifer Celeste Goodfred, D.O.

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1205878105
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1711 Issued in TN
Practice address
8970 Winchester Rd
Memphis, TN 38125-8231
Phone
(901) 794-5806
Fax
(901) 794-7922
NPI assigned
Jun 12, 2006
Last updated
May 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24106 MS
Family Medicine Physician 207Q00000X 1711 TN Primary

Addresses

Primary practice location

8970 Winchester Rd
Memphis, TN 38125-8231

Mailing address

9398 Dogwood Rd S
Germantown, TN 38139-5737
Phone (901) 378-4705

Other practice location 1

1301 Primacy Pkwy
Memphis, TN 38119-0213
Phone (901) 866-8812

Other practice location 2

7736 Airways Blvd
Southaven, MS 38671-5306
Phone (662) 772-3700

Other identifiers 6

IdentifierTypeStateIssuer
003181844AMedicaidGA
01203728MedicaidMS
3319805MedicaidTN
7100484990MedicaidKY
1205878105MedicaidMO
187976003MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060821000382 TN Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6608879267 Reassigns benefits to 1 organization
I20151229000159 MS Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6608879267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

6401 Poplar Ave
Suite 610
Memphis, TN 38119-4806
Phone (901) 761-1280

8138 Country Village Dr
Cordova, TN 38016-2029
Phone (901) 725-8606

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Merit-based Incentive Payment System (MIPS)

Final score
93 of 100Reported as group
Quality
86.11
Improvement activities
40
Cost
85.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1711TNMDMarriage & Family Therapist
24106MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Feb 1, 2021 Accepting new patients
Harpeth Medical Group, PLLC Family Medicine Past Accepting new patients
Saint Thomas Medical Partners Family Medicine Past Accepting new patients
Tennessee Urgent Care Associates, LLC Past Accepting new patients
Memphis Urgent Care #2, LLC. Family Medicine PastSince Feb 14, 2021 Accepting new patients

Locations

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

7736 Airways Blvd
Southaven, MS 38671
Phone (662) 772-3700

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

8138 Country Village Dr
Cordova, TN 38016
Phone (901) 725-8606

2100 Exeter Rd
Memphis, TN 38138
Phone (901) 757-1350

2831 Airways Blvd
Ste 102
Memphis, TN 38132
Phone (901) 348-0200

6401 Poplar Ave
Ste 610
Memphis, TN 38119
Phone (901) 227-5045

8970 Winchester Rd
Memphis, TN 38125
Phone (901) 794-5806

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Interoperability endpoints

  • Direct secure messaging: jennifer.goodfredmd.p1@direct.churchhealthcenter.nextgenshare.com
  • Direct secure messaging: jgoodfred12204@direct.bmhcc.org

Organizations & group practices 6

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1205878105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9398 DOGWOOD RD S",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381395737",
            "telephone_number": "901-378-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8970 WINCHESTER RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258231",
            "telephone_number": "901-794-5806",
            "fax_number": "901-794-7922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Primacy Pkwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381190213",
            "country_code": "US",
            "telephone_number": "901-866-8812",
            "fax_number": "901-302-2987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7736 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715306",
            "country_code": "US",
            "telephone_number": "662-772-3700",
            "fax_number": "662-772-3719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODFRED",
        "first_name": "JENNIFER",
        "middle_name": "CELESTE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24106",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181844A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01203728",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3319805",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100484990",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205878105",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187976003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.