Jason Goodijohn
Individual provider Active NPI Adult Companion · Palmyra, NE
NPI 1477367290 · NPPES record last updated Feb 3, 2025
Key facts
- NPI
- 1477367290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Companion 372600000X
- Practice address
- 982 N 10TH Rd
Palmyra, NE 68418-4012 - Phone
- (402) 740-1270
- NPI assigned
- Feb 3, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | NE | ||
| Adult Companion | 372600000X | NE | Yes |
Addresses
Primary practice location
982 N 10TH Rd
Palmyra, NE 68418-4012
Mailing address
982 N 10TH Rd
Palmyra, NE 68418-4012
Phone (402) 740-1270
Other providers in Palmyra, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.