Individual provider Active NPI

Dawn Jennifer Goedde, OD

  • Optometrist
  • Columbus, OH
National Provider Identifier
1326026071
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5462 Issued in OH
Practice address
338 W 10TH Ave
Columbus, OH 43210-1280
Phone
(614) 247-7889
Fax
(614) 247-6626
NPI assigned
Jan 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5462 OH Primary

Addresses

Primary practice location

338 W 10TH Ave
Columbus, OH 43210-1280

Mailing address

338 W 10TH Ave
Columbus, OH 43210-1280
Phone (614) 247-7889

Other names 1

  • Dawn Jennifer Burgei Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20051012000955 OH Practitioner - Optometry 3274558853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio State UniversityGroup PAC ID 6103866207, 42 clinicians

Practice addresses (Care Compare)

1664 Neil Ave
Columbus, OH 43201-2333
Phone (614) 292-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio State University CurrentSince Jul 11, 2005 Accepting new patients
Ohio State University Optometrist CurrentSince Jul 11, 2005 Accepting new patients

Locations

1664 Neil Ave
Columbus, OH 43201
Phone (614) 292-2020

338 W 10th Ave
Columbus, OH 43210
Phone (614) 292-2020

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1326026071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-247-7889",
            "fax_number": "614-247-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-247-7889",
            "fax_number": "614-247-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDDE",
        "first_name": "DAWN",
        "middle_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "BURGEI",
            "middle_name": "JENNIFER",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.