Amber L McCormick-Gossage, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2005019125 Issued in MO

Practice address

100 S Jackson St
Perryville, MO 63775-2517

Phone

(573) 547-6233

Fax

(573) 547-6765

NPI assigned

Oct 31, 2005

Last updated

Oct 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry IncGroup PAC ID 0840411799, 82 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Interoperability endpoints

• Direct secure messaging: ambergossage@direct.eyecare-partners.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarkson Optometry, Inc

  • Optometrist
  • Ellisville, MO
  • NPI 1497155345
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Inc

  dba Clarkson Eyecare

  • Optometrist
  • Elk River, MN
  • NPI 1952992976
  NPD
• Clarkson Optometry Inc

  dba Clarkson Eyecare

  • Optometrist
  • Arnold, MO
  • NPI 1053364729
  NPD (past)
• Clarkson Optometry Inc

  dba Clarkson Eyecare

  • Optometrist
  • Perryville, MO
  • NPI 1629103981
  NPD (past)
• Moreland Eyecare LLC

  • Optometrist
  • Anna, IL
  • NPI 1346468717
  NPD (past)
• Nu-Crown, LLC

  dba Crown Optical

  • Optometrist
  • Alton, IL
  • NPI 1295737294
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1013908938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JACKSON ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752517",
            "telephone_number": "573-547-6233",
            "fax_number": "573-547-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK-GOSSAGE",
        "first_name": "AMBER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2005019125",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013908938",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mattingly Boxdorfer Dental
• Emily Mattingly, DPT
• Kevin Mark Mattingly, DDS
• Mark Mattingly
• Amber Nicole Mayfield
• Erin Meixner, FNP
• David E. Melchior, D.O.
• Mercy Hospital Perry
• Mercy Hospital Perry (Mercy Hospital Perry - RHC II)
• Mercy Hospital Perry (Mercy Hospital Perry - RHC IV)

• Optometrist in Perryville, MO
• Providers in Perryville, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.