Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Adie Goodman

Individual provider Physical Therapist · NPI 1780561613

Adie Goodman is a Physical Therapist in Private Practice in Hattiesburg, Mississippi. Qualified in 2025, 1 year ago. Practices with Active Recovery LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
1
Licensed in
MS
In the registry since
2025
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Practice location Address checks out

3818 Hardy St Ste 20
Hattiesburg, MS 39402-1539
Phone: (601) 602-4652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT8073 (MS)

Record details

NPI number1780561613
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 20, 2025
Last updated in NPPESAugust 20, 2025
Certification dateAugust 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Active Recovery Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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