Jason Goodrum, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

V3007 Issued in TX

Practice address

575 Hill Country Dr Ste 101
Kerrville, TX 78028-6024

Phone

(830) 258-7090

Fax

(830) 258-7098

NPI assigned

May 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, TX2 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

Specialty

Orthopedic Surgery

Education

University of Texas Medical Branch at Galveston, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peterson Medical AssociatesGroup PAC ID 1355467887, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peterson Home Care Home health agency, Kerrville, TX, CCN 677052
• Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.goodrum.1@21041.direct.athenahealth.com

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.

• Peterson Medical Associates

  • Obstetrics & Gynecology Physician
  • Kerrville, TX
  • NPI 1770800575
  Medicare reassignment Care Compare group NPD
• Barton Healthcare System

  dba Lake Tahoe Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Zephyr Cove, NV
  • NPI 1700963725
  Medicare reassignment NPD
• Lake Tahoe Orthopaedic Institute, a Watson-Swanson Professional Corp

  dba Tahoe Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Zephyr Cove, NV
  • NPI 1609937911
  Medicare reassignment NPD
• Barton Healthcare System

  • Diagnostic Radiology Physician
  • Stateline, NV
  • NPI 1467046102
  NPD
• Lake Tahoe Orthopaedic Institute a Watson-Swanson Professional Corp

  • Durable Medical Equipment & Medical Supplies
  • Carson City, NV
  • NPI 1619126240
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sid Peterson Memorial Hospital

  dba Peterson Home Care

  • Home Health Agency
  • Kerrville, TX
  • NPI 1073582656
  Care Compare affiliation
• Sid Peterson Memorial Hospital

  dba Peterson Regional Medical Center

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  Care Compare affiliation

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1265923189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26499",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 HILL COUNTRY DR STE 101",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286024",
            "telephone_number": "830-258-7090",
            "fax_number": "830-258-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRUM",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "V3007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark P Goldman, PH. D.
• Daniel Gomez, DDS
• Estella Gonzalez, LVN
• Kendra Renee Gonzalez, MS, CCC-SLP
• Terria Shavon Goodloe, LVN
• William Hendon Gordon III, MD
• Tombra Govina, M.D.
• Kimberly Graff, PT, DPT
• James L Graham, MD
• Loyd Alton Graham, M.D.

• Orthopaedic Surgery Physician in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.