Stephanie R Goggin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009281 Issued in IL

Practice address

6620 Center Grove Road
Edwardsville, IL 62025-2802

Phone

(618) 659-1900

Fax

(618) 659-1901

NPI assigned

May 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Stephanie R Hart Former name

Medicare fee-for-service enrollment

Enrolled in IL

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Eye Care PCGroup PAC ID 0244256014, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

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

• Metro Eye Care PC

  • Optometrist
  • Edwardsville, IL
  • NPI 1598953994
  Medicare reassignment Care Compare group
• Prairie Eye Center LTD

  • Optometrist
  • Beardstown, IL
  • NPI 1376773598
  NPD (past)
• Prairie Eye Center LTD

  • Optometrist
  • Hillsboro, IL
  • NPI 1477783694
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1013965367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 CENTER GROVE RD",
            "address_2": "SUITE 3",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252802",
            "telephone_number": "618-659-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 CENTER GROVE ROAD",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252802",
            "telephone_number": "618-659-1900",
            "fax_number": "618-659-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGGIN",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - SFLD",
            "identifier": "410043847",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - HILLS",
            "identifier": "410043848",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009281",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HART",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Rose Gilomen, RDN
• Adriana Givens-Keeper, LPC
• Kelsey Godar, MSN, RN
• Kristie Goeckner, MSN, RN
• Shandra Dawn Goersch, MSN, RN
• Bryan Gomez, RBT
• Sabrina Gomez
• Haley Nichole Goodfellow, RD, LDN
• Daniel D Goran, M.D.
• Cassandra Gordon, OTR/L

• Optometrist in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.