Tamara L Goldrick, LCSW
Individual provider Active NPI Clinical Social Worker · Jackson, MO
NPI 1366073496 · NPPES record last updated Jan 28, 2020
Key facts
- NPI
- 1366073496
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2018024000 (MO)
- Practice address
- 710 Broadridge Dr
Jackson, MO 63755-3042 - Phone
- (888) 365-6271
- NPI assigned
- Jan 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.16 of 100
- Quality
- 80.99
- Improvement activities
- 40
- Cost
- 72.05
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200211002543 | MO | Practitioner - Clinical Social Worker | 5597191593 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Oaks Mental Health Associates PC | Single Specialty | Current |
Accepting new patients |
Locations
1300 County Farm Rd
Cassville, MO 65625
Phone (417) 847-3386
710 Broadridge Dr
Jackson, MO 63755
Phone (573) 243-3101
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 2018024000 | MO | Yes |
Addresses
Primary practice location
710 Broadridge Dr
Jackson, MO 63755-3042
Mailing address
3422 Glenview Dr
Cape Girardeau, MO 63701-3446
Phone (573) 270-9335
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2018024000 | Other | MO | LICENSE |
Other providers in Jackson, MO
- Kimberly Ann Glastetter-Brown
- Colleen Glenn
- Laura E Glueck
- Gold Leaf Enterprises Inc
- Gold Leaf Enterprises, Inc
- Benjamin Gail Goodier
- Grace Reliant Healthcare
- Grace Reliant Healthcare, LLC
- Gregory Erickson, LLC
- Susannah Grovenor
All providers in Jackson, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.