Individual provider Active NPI

Jeremy S Good, DC

  • Rehabilitation Chiropractor
  • Elyria, OH
National Provider Identifier
1669632253
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
4881 Issued in OH
Practice address
1599 West River St N
Elyria, OH 44035-2779
Phone
(843) 697-6994
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 4881 OH Primary

Addresses

Primary practice location

1599 West River St N
Elyria, OH 44035-2779

Mailing address

1599 West River St N
Elyria, OH 44035-2779
Phone (843) 697-6994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912000336 FL Practitioner - Chiropractic 7214004209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macdermott Group, LLCGroup PAC ID 3072653971, 3 clinicians

Practice addresses (Care Compare)

2940 Mallory Cir
Suite 205
Celebration, FL 34747-1818
Phone (407) 507-6976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4881OHMDRehabilitation Chiropractor
3335SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Macdermott Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Ohio Spine and Body 2, LLC Current Accepting new patients
Alignlife of Summerville LLC Rehabilitation Past Accepting new patients
Chiropractic and Rehabilitation of Elyria PastSince Apr 10, 2013 Accepting new patients
Te Physical Medicine at CHC of Parma PastSince Mar 31, 2015 Accepting new patients

Locations

2940 Mallory Cir
Ste 205
Kissimmee, FL 34747
Phone (407) 507-6976

Organizations & group practices 5

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1669632253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 WEST RIVER ST N",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352779",
            "telephone_number": "843-697-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 WEST RIVER ST N",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352779",
            "telephone_number": "843-697-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "JEREMY",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OH",
            "license": "4881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.

Verify at the official NPI Registry.