Active NPI
Jennifer Lynn Goddard, PT
- Physical Therapist
- Lincoln, NE
National Provider Identifier
1629151741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2375
- Practice address
- 5905 O St
Lincoln, NE 68510-2235 - Phone
- (402) 436-1905
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2375 | NE | Primary |
Addresses
Primary practice location
5905 O St
Lincoln, NE 68510-2235
Mailing address
5905 O St
Lincoln, NE 68510-2235
Phone (402) 436-1905
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025409200 | Medicaid | NE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1629151741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5905 O ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102235",
"telephone_number": "402-436-1905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 O ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102235",
"telephone_number": "402-436-1905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODDARD",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2375",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025409200",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.