Individual provider Active NPI

Jann W. Goodman, PT

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1831144385
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5005 Issued in AZ
Practice address
844 N. Ellsworth
Mesa, AZ 85207-5114
Phone
(480) 380-2810
Fax
(480) 380-2861
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5005 AZ Primary

Addresses

Primary practice location

844 N. Ellsworth
Mesa, AZ 85207-5114

Mailing address

7746 E Boston St
Mesa, AZ 85207
Phone (480) 380-2810

Other identifiers 2

IdentifierTypeStateIssuer
AZ0298870OtherAZBCBS NUMBER
755308MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003002663 AZ Practitioner - Physical Therapist in Private Practice 3678557097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

9000 E San Victor Dr
Scottsdale, AZ 85258-5051
Phone (623) 299-7784

9050 E Brown Rd
Mesa, AZ 85207-4356
Phone 4802738813775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 15, 2024 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince May 28, 2024 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 15, 2024 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince May 28, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

110 Horizon Dr
#310
Raleigh, NC 27615

Organizations & group practices 4

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1831144385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7746 E BOSTON ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85207",
            "telephone_number": "480-380-2810",
            "fax_number": "480-380-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 N. ELLSWORTH",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852075114",
            "telephone_number": "480-380-2810",
            "fax_number": "480-380-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JANN",
        "middle_name": "W.",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "AZ0298870",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755308",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.