Individual provider Active NPI

Jason Corey Goodman, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1912046889
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006691 Issued in MO
Practice address
27 Walnut Knoll CT
Saint Charles, MO 63304-4549
Phone
(636) 244-2250
NPI assigned
Feb 6, 2007
Last updated
Oct 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006691 MO Primary

Addresses

Primary practice location

27 Walnut Knoll CT
Saint Charles, MO 63304-4549

Mailing address

PO Box 8343
Chesterfield, MO 63017
Phone (314) 629-5794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Path DME LLC CurrentSince Oct 1, 2025 Accepting new patients
Preston Chiropractic and Rehabilitation LLC Chiropractor Past Accepting new patients
Crockett Chiropractic, PC Chiropractor PastSince Jul 31, 2006 Accepting new patients
Grace Spine LLC Chiropractor Past Accepting new patients
Gray Family Chiropractic PLLC Chiropractor PastSince May 10, 2017 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1912046889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8343",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-629-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 WALNUT KNOLL CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633044549",
            "telephone_number": "636-244-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JASON",
        "middle_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.