NPIMap

Individual provider Active NPI

Hadden F Goodman, PA-C

  • Physician Assistant
  • Alpine, WY
National Provider Identifier
1942493630
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
433 Issued in WY
Practice address
23 Elkrun Hwy 89
Alpine, WY 83128
Phone
(307) 654-7138
Fax
(307) 654-7201
NPI assigned
Aug 25, 2007
Last updated
Apr 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X WY433 WY
Physician Assistant 363A00000X 433 WY Primary

Addresses

Primary practice location

23 Elkrun Hwy 89
Alpine, WY 83128

Mailing address

P.O. Box 3047
Alpine, WY 83128
Phone (307) 654-7138

Other identifiers 1

IdentifierTypeStateIssuer
605960009OtherWYUSDLAB

Other names 1

  • Hadden Forry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000298 WY Practitioner - Physician Assistant 9931289832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics of Jackson Hole PCGroup PAC ID 9436042322, 14 clinicians

Practice addresses (Care Compare)

555 E Broadway Ave
Jackson, WY 83001-8640
Phone (307) 733-3900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
WY433WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care of Jackson Hole, LLC Past Accepting new patients
Pegasus Emergency Group Wyoming LLC Past Accepting new patients
Jackson Hole Medical Clinic, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hadden.goodman.p1@direct.tetonortho.nextgenshare.com
  • Direct secure messaging: hgoodman@tetonortho.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1188000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1942493630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3047",
            "city": "ALPINE",
            "state": "WY",
            "postal_code": "83128",
            "telephone_number": "307-654-7138",
            "fax_number": "307-654-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ELKRUN HWY 89",
            "city": "ALPINE",
            "state": "WY",
            "postal_code": "83128",
            "telephone_number": "307-654-7138",
            "fax_number": "307-654-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "HADDEN",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-25",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "WY433",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDLAB",
            "identifier": "605960009",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HADDEN",
            "last_name": "FORRY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alpine, WY

Sources for this page

Verify at the official NPI Registry.