JENNIFER GODDARD (M.D.) – Family Medicine Physician, NPI 1124257282
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,260 FAMILY PRACTICE in AZ
Provider Addresses for JENNIFER GODDARD (M.D.)
1050 GAIL GARDNER WAY STE 100
PRESCOTT, AZ 863051631
Phone: (928) 777-0700
Fax: (928) 445-4464
Type: Location
1050 Gail Gardner Way Ste 300
Prescott, AZ 863051640
Phone: (928) 717-5232
Fax: (928) 717-5238
Type: Location
PO BOX 10880
PRESCOTT, AZ 863040880
Phone: (602) 406-4786
Fax: (916) 636-4358
Type: Mailing
Box Street, Port Charlotte, Charlotte County, Florida, 33948, United States
CHARLOTTE, NC 282751649
Phone: (843) 789-1620
Fax: (843) 724-2440
Type: Mailing
1879, Savage Road, Orleans Woods, Charleston, Charleston County, South Carolina, 29407, United States
CHARLESTON, SC 29407
Phone: (843) 763-9472
Fax: (843) 763-7411
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2023-05-22 • Largest payer in this snapshot: Abbott Laboratories ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-07-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210723001555 | I | Family Practice | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 829 | 452 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 336 | 336 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 214 | 162 | $0 |
| G0009 | Administration of pneumococcal vaccine | 93 | 93 | $0 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 82 | 82 | $0 |
Insurance plans in this area (ZIP 86305)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Orthopedic Surgery | AZ | |
| Physician Assistant | AZ | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | SC | |
| - | TN | |
| Cardiovascular Disease (Cardiology) | AZ | |
| - | AZ | |
| P S Y C H I A T R Y | AZ | |
| Nurse Practitioner | AZ |
Reviews
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