Individual provider Active NPI

Andrew Lee Gooden, CRNA

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1386984615
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2019003627 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 781-2727
NPI assigned
Feb 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2019003627 MO Primary
Certified Registered Nurse Anesthetist 367500000X COA.14539NA OH
Certified Registered Nurse Anesthetist 367500000X RN.391120-1 OH

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

One Children'S Plaza
Dayton Children'S Hospital-Children'S Anesthesia Group,
Dayton, OH 45404-1815
Phone (937) 641-3350

Other practice location 1

One Children's Plaza
Dayton Children's Hospital-Children's Care Group, Inc.
Dayton, OH 45404-1815
Phone (937) 641-3350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190225000420 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173764701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Missouri LLCGroup PAC ID 4082908249, 88 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-3729

Hospital & facility affiliations

  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
COA.14539NAOHMDCertified Registered Nurse Anesthetist
RN.391120-1OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Missouri, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 18, 2019 Accepting new patients
Pediatric Anesthesia Associates of Dayton, Inc. Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1361577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1386984615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CHILDREN'S PLAZA",
            "address_2": "DAYTON CHILDREN'S HOSPITAL-CHILDREN'S ANESTHESIA GROUP,",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3350",
            "fax_number": "937-641-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Children's Plaza",
            "address_2": "Dayton Children's Hospital-Children's Care Group, Inc.",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041815",
            "country_code": "US",
            "telephone_number": "937-641-3350",
            "fax_number": "937-641-6145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODEN",
        "first_name": "ANDREW",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-23",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019003627",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.14539NA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.391120-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.