Active NPI
Marilyn F Goodman, DC
- Chiropractor
- Waco, TX
National Provider Identifier
1215077953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5753
- Practice address
- 7524 Bosque Blvd
Ste D
Waco, TX 76712-3772 - Phone
- (254) 776-1030
- Fax
- (254) 732-3314
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5753 | TX | Primary |
Addresses
Primary practice location
7524 Bosque Blvd
Ste D
Waco, TX 76712-3772
Mailing address
PO Box 7891
Waco, TX 76714-7891
Phone (254) 776-1030
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015950 01 | Medicaid | TX | |
| 83410X | Other | TX | BLUE CROSS ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221003002962 | TX | Practitioner - Chiropractic | 0143485425 | Practice locations: Waco, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7524 Bosque Blvd
Suite D
Waco, TX 76712-3772
Phone (254) 776-1030
7524 Bosque Blvd D
Waco, TX 76712-3772
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5753 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1215077953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7891",
"city": "WACO",
"state": "TX",
"postal_code": "767147891",
"telephone_number": "254-776-1030",
"fax_number": "254-732-3314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7524 BOSQUE BLVD",
"address_2": "STE D",
"city": "WACO",
"state": "TX",
"postal_code": "767123772",
"telephone_number": "254-776-1030",
"fax_number": "254-732-3314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "MARILYN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "5753",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015950 01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ID NUMBER",
"identifier": "83410X",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.