Goose Creek Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

GOOSE CREEK PEDIATRICS PC

Practice address

1701 W 5TH St
Ste a
Sheridan, WY 82801-2748

Phone

(307) 672-7700

NPI assigned

Jun 21, 2006

Last updated

Aug 22, 2020By 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

Mary I Bowers, MDNPI 1023047339

Title

Owner

Phone

(307) 672-7700

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/a59cbcd4-c01a-47b0-9162-736ddb19e2b1/

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary I Bowers, MD

  • Pediatrics Physician
  • Sheridan, WY
  • NPI 1023047339
  Authorized official Same address or phone

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407892300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W 5TH ST",
            "address_2": "STE A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012748",
            "telephone_number": "307-672-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W 5TH ST",
            "address_2": "STE A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012748",
            "telephone_number": "307-672-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOSE CREEK PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-672-7700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTANA MEDICAID",
            "identifier": "8820875",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Sue Goffena, MSW
• Gologo Inc
• Shaun Jeffrey Gonda, MD
• Goose Creek Dental Clinic
• Goose Creek Family Practice, P.C.
• Lynn Euvoynne Gordon, MS, LPC, NCC
• Nicole C Gore, DMD
• Amy Gorzalka, CCC-SLP
• Joanne Brewster Goss, MS, ATC, LAT
• Chandler Bryse Gotfried, PSYD

• Pediatrics Physician in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Pediatrics Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.