Individual provider Active NPI

Jody Lynn Goodson, PT

  • Physical Therapist
  • Saint Joseph, MI
National Provider Identifier
1619447752
Registry record updated Dec 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013037 Issued in MI
Practice address
4066 Red Arrow Hwy Ste a
Saint Joseph, MI 49085-9209
Phone
(269) 408-0494
Fax
(269) 408-0492
NPI assigned
Dec 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501013037 MI Primary

Addresses

Primary practice location

4066 Red Arrow Hwy Ste a
Saint Joseph, MI 49085-9209

Mailing address

8833 Beechwood CT
Berrien Center, MI 49102-8721
Phone (269) 357-3737

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501013037MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Nursing Care Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1543708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543708800000",
    "number": "1619447752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8833 BEECHWOOD CT",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491028721",
            "telephone_number": "269-357-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 RED ARROW HWY STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859209",
            "telephone_number": "269-408-0494",
            "fax_number": "269-408-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-02",
        "last_updated": "2018-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.