Good Shepherd Family Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2007021133 Issued in MO

Legal business name

GOOD SHEPHERD FAMILY CLINIC INC

Doing business as

Good Shepherd Family Clinic

Practice address

112 Business Park Dr
Branson, MO 65616-7426

Phone

(417) 335-5022

Fax

(417) 335-5044

NPI assigned

Oct 1, 2009

Last updated

Oct 1, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie Sue Olson

Title

Office Manager

Phone

(417) 335-5022

Specialties & licenses 1

Addresses

Other names 1

• Good Shepherd Family Clinic Doing business as

Locations

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1396079711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BUSINESS PARK DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167426",
            "telephone_number": "417-335-5022",
            "fax_number": "417-335-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BUSINESS PARK DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167426",
            "telephone_number": "417-335-5022",
            "fax_number": "417-335-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD FAMILY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "417-335-5022",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007021133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derrick Gilbert, CRADC
• Nicole L Gillard, OTR/L, ATP
• Roy Jack Gillispie, MD
• Jerry Samuel Givens, M.D.
• Teresa K Givens, CRNA
• Max H Goodwin, M.D.
• Kelli Rae Gosch, W.H.C.N.P.
• Mackenzie Ladane Green
• Justin Matthew Gregory, DC
• Micah Griffin, PA-C

• Family Medicine Physician in Branson, MO
• Providers in Branson, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.