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JERRY L GODDARD M.D.
NPI 1295711240
Family Medicine in Carbondale, IL

Active since December 21, 2005PECOS EnrolledAccepts Medicare Assignment
305 W JACKSON ST, STE 200, CARBONDALE, IL 62901(618) 536-6621(618) 453-1102 Get Directions Write a Review

NPPES record last updated: December 28, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 28, 2020, Dec 23, 2020, Oct 3, 2018 (3 updates tracked since 2018).

About Jerry L Goddard M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY L GODDARD M.D. (NPI 1295711240) is an individual family medicine provider in Carbondale, Illinois, licensed in Illinois (036-054846) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in West Frankfort, and is a graduate of Tulane University School Of Medicine (1970).

NPPES Registry Identity

NPI1295711240
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJERRY L GODDARDCredential: M.D.
Location Address305 W JACKSON ST, STE 200Carbondale, IL 62901-1474
Mailing Address305 W Jackson St, Ste 200Carbondale, IL 62901-1474 · (618) 536-6621 · Fax (618) 453-1102
Phone(618) 536-6621
Fax(618) 453-1102
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 1970
Enumeration DateDecember 21, 2005
Last NPPES UpdateDecember 28, 20203 updates tracked since enumeration
NPPES CertifiedDecember 28, 2020
✔ NPI 1295711240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036-054846
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X · License 036-054846 (IL)
305 W JACKSON ST, Carbondale, IL 62901
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Secondary Practice Location 1

Location 12553 Ken Gray BlvdWest Frankfort, IL 62896-4174 · Phone (618) 932-3937 · Fax (618) 932-2734

Other Identifiers 1

Medicaid036054846IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jerry L Goddard M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436259058
PECOS Enrollment IDI20080326000046
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. BRADLEY C. BRUSH A.T.C., C.S.C.S.
Specialist/Technologist (Athletic Trainer)
305 W JACKSON ST, SUITE LL02
CARBONDALE, IL 62901
Jackson County (618) 549-0721
STOKES INSTITUTE OF UROLOGY, LLC
Specialist
305 W JACKSON ST, SUITE 400
CARBONDALE, IL 62901
Jackson County (618) 351-9300
MR. MICHAEL LEROY MATTESON PA C
Physician Assistant (Surgical)
305 W JACKSON ST, SUITE 105
CARBONDALE, IL 62901
Jackson County (618) 536-2565
L. NEAL MCCAIN, M.D, LTD.
Surgery
305 W JACKSON ST, SUITE 302
CARBONDALE, IL 62901
Jackson County (618) 529-1770
SCOTT K SCHONEWOLF M.D.
Family Medicine
305 W JACKSON ST, SUITE 200
CARBONDALE, IL 62901
Jackson County (618) 453-3777
LAURA E CHANDLER MS/CCC-SLP
Speech-Language Pathologist
305 W JACKSON ST, SUITE LL02
CARBONDALE, IL 62901
Jackson County (618) 529-0516
KUSHAN D. MOONESINGHE M.D.
Family Medicine
305 W JACKSON ST, STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
KYAW T NAING M.D., PH.D.
Family Medicine
305 W JACKSON ST, STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Goddard's NPI number?

The NPI number for Jerry Goddard is 1295711240. It was assigned to this individual provider in the NPPES registry on December 21, 2005.

Where is Jerry Goddard located?

Jerry Goddard practices at 305 W Jackson St Ste 200, Carbondale, IL 62901. The listed phone number is (618) 536-6621.

What is Jerry Goddard's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jerry Goddard enrolled in Medicare?

Yes. Jerry Goddard is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jerry Goddard was last updated on December 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.