Organization Active NPI

Goodwin Chiropractic Center

  • Chiropractor
  • Summersville, WV
National Provider Identifier
1790883577
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
775 Issued in WV
Legal business name
GOODWIN CHIROPRACTIC CENTER
Practice address
1018 Broad St
Summersville, WV 26651-1711
Phone
(304) 872-1006
Fax
(304) 872-5994
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Dr. Thomas Goodwin, D.C.NPI 1821196692
Title
Clinic Director
Phone
(304) 872-1006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 775 WV Primary

Addresses

Primary practice location

1018 Broad St
Summersville, WV 26651-1711

Mailing address

1018 Broad St
Summersville, WV 26651-1711
Phone (304) 872-1006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060224000159 WV Part B Supplier - Clinic/Group Practice 2668488925 Receives reassigned benefits from 1 practitioner
Practice locations: Summersville, WV

National Provider Directory

National Provider Directory

Locations

1018 Broad St
Summersville, WV 26651
Phone (304) 872-1006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1790883577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511711",
            "telephone_number": "304-872-1006",
            "fax_number": "304-872-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 BROAD ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511711",
            "telephone_number": "304-872-1006",
            "fax_number": "304-872-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWIN CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "304-872-1006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.