Individual provider Active NPI

William B Goble, D.O.

  • Family Medicine Physician
  • Waukee, IA
National Provider Identifier
1063669968
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4080 Issued in IA
Practice address
1025 SE Tallgrass Lane Ste 150
Waukee, IA 50263
Phone
(515) 875-8070
Fax
(515) 875-8071
NPI assigned
Aug 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4080 IA Primary

Addresses

Primary practice location

1025 SE Tallgrass Lane Ste 150
Waukee, IA 50263

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9925

Other practice location 1

1410 SW Tradition Dr Ste 120
Ankeny, IA 50023
Phone (515) 875-9040

Other practice location 2

5950 University Ave Ste 105
West Des Moines, IA 50266-7756
Phone (515) 875-9070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandongoble@tic.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100813001035 IA Practitioner - Family Practice 8426182346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

5950 University Ave
Suite 105
West Des Moines, IA 50266-7756
Phone (515) 875-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4080IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC Family Medicine CurrentSince Jan 15, 2018 Accepting new patients
The Iowa Clinic, PC CurrentSince Jan 15, 2018 Accepting new patients

Locations

1410 SW Tradition Dr
Ste 120
Ankeny, IA 50023
Phone (515) 875-9040

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

1025 SE Tallgrass Ln
Ste 150
Waukee, IA 50263
Phone (515) 875-8070

5950 University Ave
Ste 105
West Des Moines, IA 50266
Phone (515) 875-9070

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Interoperability endpoints

  • Direct secure messaging: brandongoble@tic.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1063669968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SE TALLGRASS LANE STE 150",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "50263",
            "telephone_number": "515-875-8070",
            "fax_number": "515-875-8071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 SW Tradition Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "50023",
            "country_code": "US",
            "telephone_number": "515-875-9040",
            "fax_number": "515-875-9041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5950 University Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502667756",
            "country_code": "US",
            "telephone_number": "515-875-9070",
            "fax_number": "515-875-9071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOBLE",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-21",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "4080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandongoble@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5950 University Ave Ste 105",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502667756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukee, IA

Sources for this page

Verify at the official NPI Registry.