Jessica K Goodfellow, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4330 Issued in OK

Practice address

21065 Powerline Rd
Suite a 2
Boca Raton, FL 33433-2313

Phone

(561) 883-7800

Fax

(561) 883-7801

NPI assigned

Jan 17, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Florida Movement Therapy Center-Boca Raton, LLC

  • Geriatric Physical Therapist
  • Boca Raton, FL
  • NPI 1407118268
  NPD

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1780989160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 SW 44TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058046",
            "telephone_number": "580-574-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21065 POWERLINE RD",
            "address_2": "SUITE A 2",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334332313",
            "telephone_number": "561-883-7800",
            "fax_number": "561-883-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "JESSICA",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-17",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT4330",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "27762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goo LLC Total Musculoskeletal Care
• Good Health Orbit Inc
• Good Living Habits, LLC
• Heather Kristine Good
• Jeffrey M Good, MD
• Goodlife Pharmacy Inc
• Goodlife Pharmacy Inc
• Alexsey Goodman
• Brian Goodman
• Michael Dean Goodman, PH.D., MINISTER

• Physical Therapist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.