Individual provider Active NPI

William Barton Goodman, D.C.

  • Chiropractor
  • Thousand Oaks, CA
National Provider Identifier
1992854574
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17440 Issued in CA
Practice address
425 Lombard St
Thousand Oaks, CA 91360-5898
Phone
(805) 495-2735
Fax
(805) 495-7406
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC17440 CA Primary

Addresses

Primary practice location

425 Lombard St
Thousand Oaks, CA 91360-5898

Mailing address

425 Lombard St
Thousand Oaks, CA 91360-5898
Phone (805) 495-2735

Other identifiers 1

IdentifierTypeStateIssuer
DC017440OtherCABLUE SHIELD PROVIDER NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229000618 CA Practitioner - Chiropractic 2365630738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodman Chiropractic Professional CorporationGroup PAC ID 2062600430, 2 clinicians

Practice addresses (Care Compare)

425 Lombard St
Thousand Oaks, CA 91360-5898
Phone (805) 495-2735

425 Lombard St
Thousand Oaks, CA 91360-8218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC17440CAMDChiropractor
17440CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Goodman Chiropractic Professional Corporation Chiropractor CurrentSince Nov 21, 2010 Accepting new patients

Locations

425 Lombard St
Thousand Oaks, CA 91360
Phone (805) 494-4145

468 Pennsfield Pl
Ste 105
Thousand Oaks, CA 91360
Phone (805) 495-2735

Organizations & group practices 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992854574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LOMBARD ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605898",
            "telephone_number": "805-495-2735",
            "fax_number": "805-495-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 LOMBARD ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605898",
            "telephone_number": "805-495-2735",
            "fax_number": "805-495-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "WILLIAM",
        "middle_name": "BARTON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NO.",
            "identifier": "DC017440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.