Active NPI
Matthew J Goedken, DC
- Chiropractor
- Madison, WI
National Provider Identifier
1336472794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4540 12
- Practice address
- 1702 Eagan Rd
Madison, WI 53704-3702 - Phone
- (608) 243-1234
- NPI assigned
- Sep 16, 2009
- Last updated
- Sep 16, 2009
- Sex
- Male
- 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 | 4540 12 | WI | Primary |
Addresses
Primary practice location
1702 Eagan Rd
Madison, WI 53704-3702
Mailing address
1702 Eagan Rd
Madison, WI 53704-3702
Phone (608) 243-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4540 12 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilder Chiropractic, Inc. | Past | Accepting new patients | |
| Chiro One Wellness Center of Madison West, LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Madison, WI
- NPI 1841857604
-
dba Madison Chiropractic East Madison Chiropractic West
- Clinic/Center
- Madison, WI
- NPI 1457410458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1336472794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 EAGAN RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537043702",
"telephone_number": "608-243-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 EAGAN RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537043702",
"telephone_number": "608-243-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEDKEN",
"first_name": "MATTHEW",
"middle_name": "J",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-16",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "4540 12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.