Individual provider Active NPI

Kylee Goddard, OD

  • Optometrist
  • Springfield, MO
National Provider Identifier
1255916052
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03116 Issued in MO
Practice address
2825 S Glenstone Ave Ste 113
Springfield, MO 65804-3728
Phone
(417) 887-6883
Fax
(417) 887-6884
NPI assigned
Mar 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03116 MO Primary

Addresses

Primary practice location

2825 S Glenstone Ave Ste 113
Springfield, MO 65804-3728

Mailing address

2825 S Glenstone Ave Ste 113
Springfield, MO 65804-3728
Phone (417) 887-6883

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210803000428 MO Practitioner - Optometry 7618371303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Springfield Eyecare, LLCGroup PAC ID 9234105008, 2 clinicians

Practice addresses (Care Compare)

101 N Range Line Rd
Suite 186
Joplin, MO 64801-4118
Phone (417) 782-9151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Onsite Eyecare, LLC Optometrist CurrentSince Jun 20, 2023 Accepting new patients
Springfield Eyecare, LLC Optometrist CurrentSince Jan 1, 2022 Accepting new patients

Locations

101 N Range Line Rd
Ste 186
Joplin, MO 64801
Phone (417) 782-9151

709 E McCracken Rd
Ozark, MO 65721
Phone (417) 581-0468

2825 S Glenstone Ave
Ste 113
Springfield, MO 65804
Phone (417) 887-6883

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": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1255916052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 S GLENSTONE AVE STE 113",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043728",
            "telephone_number": "417-887-6883",
            "fax_number": "417-887-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 S GLENSTONE AVE STE 113",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043728",
            "telephone_number": "417-887-6883",
            "fax_number": "417-887-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "KYLEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.