Active NPI
Todd M Goodwin, D.C.
- Sports Physician Chiropractor
- Kingsley, IA
National Provider Identifier
1396861266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 06397
- Practice address
- 30 W. 2ND STR.
Kingsley, IA 51028 - Phone
- (712) 378-2958
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 06397 | IA | Primary |
Addresses
Primary practice location
30 W. 2ND STR.
Kingsley, IA 51028
Mailing address
PO Box 485
Kingsley, IA 51028-0485
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0230359 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120509000532 | IA | Practitioner - Chiropractic | 2668634569 | Practice locations: Kingsley, IA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
30 W 2ND St
Kingsley, IA 51028-7708
Phone (712) 378-2958
PO Box
Suite 397
Kingsley, IA 51028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06397 | IA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396861266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 485",
"city": "KINGSLEY",
"state": "IA",
"postal_code": "510280485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W. 2ND STR.",
"city": "KINGSLEY",
"state": "IA",
"postal_code": "51028",
"telephone_number": "712-378-2958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "TODD",
"middle_name": "M",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "IA",
"license": "06397",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0230359",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingsley, IA
- Damon Lee Bowman
- Care Initiatives (Kingsley Specialty Care)
- City of Kingsley
- Katie Ann Howe, PHARMD
- Iowa Physicians Clinic Medical Foundation (Unitypoint Clinic Family Medicine - Kingsley)
- Karl & Sara Koelling DDS, P.C. (Kingsley Dental Clinic)
- Kingsley Drug Inc (Kingsley Drug)
- Kingsley Drug Inc LTC (Kingsley Drug)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.