Matthew Scott Goodrich, D.C
Individual provider Active NPI Chiropractor · Eagle Point, OR
NPI 1679831382 · NPPES record last updated Dec 6, 2016
Key facts
- NPI
- 1679831382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038012175 (IL)
- Practice address
- 1296 S Shasta Ave
Eagle Point, OR 97524-8521 - Phone
- (541) 830-4325
- Fax
- (541) 826-2620
- NPI assigned
- May 1, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Complete Care Chiropractic and Massage
Practice addresses (Care Compare)
1296 S Shasta Ave
Eagle Point, OR 97524-8521
Phone (541) 830-4325
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151208002620 | OR | Practitioner - Chiropractic | 3971754656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038012175 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Care Chiropractic and Massage | Current |
Accepting new patients | |
| Litchfield Physical Medicine LTD | Chiropractor | Past |
Accepting new patients |
| Complete Integrative Care, LLC | Past |
Accepting new patients | |
| Litchfield Physical Medicine, LTD | Chiropractor | Past | Accepting new patients |
Locations
1296 S Shasta Ave
Eagle Point, OR 97524
Phone (541) 830-4325
3132 State St
Ste 110
Medford, OR 97504
Phone (541) 732-1686
Interoperability endpoints
- matthew.goodrich.1@12515.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038012175 | IL | Yes |
Addresses
Primary practice location
1296 S Shasta Ave
Eagle Point, OR 97524-8521
Mailing address
171 Candice Cir
Medford, OR 97504-9609
Phone (412) 651-3022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500696480 | Medicaid | OR |
Other providers in Eagle Point, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.