Individual provider Active NPI

John L Good, OD

  • Optometrist
  • Prescott, AZ
National Provider Identifier
1831283498
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1268 Issued in NE
Practice address
1022 Willow Creek Rd
Prescott, AZ 86301-1607
Phone
(284) 451-3419
Fax
(928) 778-3993
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1268 NE Primary

Addresses

Primary practice location

1022 Willow Creek Rd
Prescott, AZ 86301-1607

Mailing address

1022 Willow Creek Rd
Prescott, AZ 86301-1607
Phone (284) 451-3419

Other practice location 1

2517 N Great Western Dr
Prescott Valley, AZ 86314-2597
Phone (928) 445-1341 ext. 239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827005162 AZ Practitioner - Optometry 2062804164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rummel Eye Care, P.C.Group PAC ID 7618865841, 5 clinicians

Practice addresses (Care Compare)

1022 Willow Creek Rd
Suite 200
Prescott, AZ 86301-1609
Phone (928) 445-1341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1268NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rummel Eye Care, P.C. CurrentSince Jun 14, 2025 Accepting new patients
Rummel Eye Care, P.C. Past Accepting new patients

Locations

1022 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-1341

1022 Willow Creek Rd
Ste 200
Prescott, AZ 86301
Phone (520) 445-1341

Organizations & group practices 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1831283498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011607",
            "telephone_number": "284-451-3419",
            "fax_number": "928-778-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011607",
            "telephone_number": "284-451-3419",
            "fax_number": "928-778-3993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2517 N Great Western Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142597",
            "country_code": "US",
            "telephone_number": "928-445-1341 x239",
            "fax_number": "928-778-3993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOOD",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.