Active NPI
Katherine E. McGoogan, MD
- Pediatric Gastroenterology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- ME101395
- Practice address
- 807 Childrens Way
Nemours Childrens Clinic
Jacksonville, FL 32207-8426 - Phone
- (904) 697-3694
- Fax
- (904) 697-3927
- NPI assigned
- Jun 19, 2007
- Last updated
- Sep 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 127907 | NC | |
| Pediatric Gastroenterology Physician | 2080P0206X | ME 101395 | FL | |
| Pediatric Gastroenterology Physician | 2080P0206X | ME101395 | FL | Primary |
Addresses
Primary practice location
807 Childrens Way
Nemours Childrens Clinic
Jacksonville, FL 32207-8426
Mailing address
PO Box 191
Provider Enrollment
Rockland, DE 19732-0191
Phone (302) 651-6212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127907 | NC | MD | Pediatrics Physician |
| ME 101395 | FL | MD | Pediatric Gastroenterology Physician |
| ME101395 | FL | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
14785 Old St Augustine Rd
#200
Jacksonville, FL 32258
807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600
Interoperability endpoints
- kmcgoogan33913@direct.nemours.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1386658615
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Children's Hospital
- Wilmington, DE
- NPI 1467505073
-
dba Memorial Hospital and Manor
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1407051527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"address_2": "PROVIDER ENROLLMENT",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-6212",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 CHILDRENS WAY",
"address_2": "NEMOURS CHILDRENS CLINIC",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078426",
"telephone_number": "904-697-3694",
"fax_number": "904-697-3927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOOGAN",
"first_name": "KATHERINE",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-19",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "127907",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "FL",
"license": "ME 101395",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "FL",
"license": "ME101395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
- Lisa McGill
- Donna McGinley, PH.D., LMHC
- Nicole McGlinchy, MMS, PA-C
- Patricia McGlothlin, MA, NCC, LMHC
- Kelly McGonigle
- Katelin Hale McGory
- Edward Kenneth McGough, MD
- Margaret Ann McGovern-Poore, DO
- McGowan Medical Centers, PA (McGowan Spinal Rehabilitation Center)
- McGowan Spinal Rehabilitation Center PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.