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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

CHAD BRIAN GOODERHAM FNP
NPI 1639153091
Nurse Practitioner - Family in Fort Wainwright, AK

Active since November 30, 2005PECOS Enrolled
1060 GAFFNEY RD, FORT WAINWRIGHT, AK 99703(907) 353-5286 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

About Chad Brian Gooderham Fnp NPPES

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

CHAD BRIAN GOODERHAM FNP (NPI 1639153091) is an individual family provider in Fort Wainwright, Alaska, licensed in Wisconsin (1927-033) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639153091
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameCHAD BRIAN GOODERHAMCredential: FNP
Location Address1060 GAFFNEY RDFort Wainwright, AK 99703-5001
Mailing Address1123 Shannon DrFairbanks, AK 99701-3811 · (907) 457-5158
Phone(907) 353-5286
Sole ProprietorNo
Enumeration DateNovember 30, 2005
Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration
✔ NPI 1639153091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in WI · 1927-033
1060 GAFFNEY RD, Fort Wainwright, AK 99703
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chad Brian Gooderham Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 99703 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
$111.57 typical visit price
range $71.33 – $222.64
Typical copayment $27.89 (range $17.83 – $55.66)
Most-billed visit code 99203
Established Patient
$128.73 typical visit price
range $21.84 – $181.48
Typical copayment $32.18 (range $5.46 – $45.37)
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.

LAURA NOWELS KASTER M.D.
Family Medicine
1060 GAFFNEY RD, BASSETT ARMY COMMUNITY HOSPITAL
FORT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (907) 361-5200
MRS. ANITA PREWITT R.D.H.
Dental Hygienist
1060 GAFFNEY RD
FORT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (907) 353-5530
DR. DANITA NEVITT KOEHLER MD
Emergency Medicine
1060 GAFFNEY RD
FT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (907) 361-5345
MRS. LISA K. GRIFFIN PA-C
Physician Assistant
1060 GAFFNEY RD
FT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (907) 353-5418
ARIANNE JULIENE HENRY-KROLL MSW
Social Worker (Clinical)
1060 GAFFNEY RD
FT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (561) 656-2345
STEPHANIE HEAVNER
Registered Nurse (Community Health)
1060 GAFFNEY RD
FORT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (907) 361-5692
DR. CHRISTOPHER J. GORMLEY PHARMD
Pharmacist
1060 GAFFNEY RD
FORT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (508) 558-0585
DR. SHIANNA RENAE WALKER PH.D.
Clinical Neuropsychologist
1060 GAFFNEY RD, #7440
FORT WAINWRIGHT, AK 99703
Fairbanks North Star Borough (907) 361-5418

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 Chad Gooderham's NPI number?

The NPI number for Chad Gooderham is 1639153091. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Chad Gooderham located?

Chad Gooderham practices at 1060 Gaffney Rd, Fort Wainwright, AK 99703. The listed phone number is (907) 353-5286.

What is Chad Gooderham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Chad Gooderham enrolled in Medicare?

Yes. Chad Gooderham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Chad Gooderham was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.