Organization Active NPI

Goodman Chiropractic Professional Corporation

  • Chiropractor
  • Thousand Oaks, CA
National Provider Identifier
1245445220
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GOODMAN CHIROPRACTIC PROFESSIONAL CORPORATION
Practice address
425 Lombard St
Thousand Oaks, CA 91360-5898
Phone
(805) 495-2735
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

Name
Mrs. Geraldine B. Goodman
Title
Clinic Director
Phone
(805) 495-2735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

425 Lombard St
Thousand Oaks, CA 91360-5898

Mailing address

425 Lombard St
Thousand Oaks, CA 91360-5898
Phone (805) 495-2735

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101229000652 CA Part B Supplier - Clinic/Group Practice 2062600430 Receives reassigned benefits from 2 practitioners
Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

468 Pennsfield Pl
Ste 105
Thousand Oaks, CA 91360
Phone (805) 495-2735

425 Lombard St
Thousand Oaks, CA 91360
Phone (805) 494-4145

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1245445220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LOMBARD ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605898",
            "telephone_number": "805-495-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 LOMBARD ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605898",
            "telephone_number": "805-495-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODMAN CHIROPRACTIC PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "805-495-2735",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.