NPIMap

Individual provider Active NPI

Jason A. Goodin, D.O.

  • Pulmonary Disease Physician
  • Columbia, MO
National Provider Identifier
1629165436
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2006016594 Issued in MO
Practice address
1705 East Broadway
Suite 280
Columbia, MO 65201-7185
Phone
(573) 815-7119
Fax
(573) 815-7116
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 2006016594 MO Primary

Addresses

Primary practice location

1705 East Broadway
Suite 280
Columbia, MO 65201-7185

Mailing address

1705 East Broadway
Suite 280
Columbia, MO 65201-7185
Phone (573) 815-7119

Other identifiers 1

IdentifierTypeStateIssuer
200011712MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120816000099 MO Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4587810049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Kansas City University of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1705 E Broadway
Suite 280
Columbia, MO 65201-7185
Phone (573) 815-7119

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2006016594MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chas Physician Services LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jasongoodin@mhccaremail.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1629165436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 EAST BROADWAY",
            "address_2": "SUITE 280",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017185",
            "telephone_number": "573-815-7119",
            "fax_number": "573-815-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 EAST BROADWAY",
            "address_2": "SUITE 280",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017185",
            "telephone_number": "573-815-7119",
            "fax_number": "573-815-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODIN",
        "first_name": "JASON",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2006016594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200011712",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.