NPIMap

Individual provider Active NPI

Nicole Marie Goddard, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Wilmington, OH
National Provider Identifier
1982967428
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
34.012426 Issued in OH
Practice address
720 Elm St
Wilmington, OH 45177-2476
Phone
(513) 354-3700
Fax
(513) 354-7651
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NOT YET ISSUED WV
Sports Medicine (Family Medicine) Physician 207QS0010X 34.012426 OH Primary

Addresses

Primary practice location

720 Elm St
Wilmington, OH 45177-2476

Mailing address

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247-7961
Phone (513) 354-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160907000558 OH Practitioner - Sports Medicine 5597051201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
West Virginia School of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beacon Orthopaedics and Sports Medicine LTDGroup PAC ID 0345136412, 471 clinicians

Practice addresses (Care Compare)

500 E Business Way
Cincinnati, OH 45241-2374
Phone (513) 251-7827

Hospital & facility affiliations

  • Trihealth Clinton Regional Hospital Hospital, Wilmington, OH, CCN 360175
  • Highland District Hospital Hospital, Hillsboro, OH, CCN 361332
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134
  • Ohio Living Cape May Nursing home, Wilmington, OH, CCN 366415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
NOT YET ISSUEDWVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Aug 15, 2016 Accepting new patients
Beacon Orthopaedics & Sports Medicine, LTD CurrentSince Aug 15, 2016 Accepting new patients

Locations

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

3950 Red Bank Rd
Cincinnati, OH 45227
Phone (513) 246-8840

6480 Harrison Ave
Ste 100
Cincinnati, OH 45247

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

500 E Business Way
Ste A
Cincinnati, OH 45241
Phone (513) 389-3666

500 E Business Way
Sharonville, OH 45241
Phone (513) 251-7827

720 Elm St
Wilmington, OH 45177
Phone (937) 283-2186

720 Elm St
Ste C
Wilmington, OH 45177
Phone (937) 283-2186

Interoperability endpoints

  • Direct secure messaging: nicole.goddard.p1@direct.beaconortho.nextgenshare.com

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.

Hospital & facility affiliations 10

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1982967428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE",
            "address_2": "SUITE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ELM ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772476",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "NOT YET ISSUED",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "34.012426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

Verify at the official NPI Registry.