Individual provider Active NPI

Gordon Melvin Goldman, M.D.

  • Obstetrics & Gynecology Physician
  • Chesterfield, MO
National Provider Identifier
1417066044
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
30541 Issued in MO
Practice address
226 S Woods Mill Rd
Suite 60W
Chesterfield, MO 63017-3662
Phone
(314) 878-7333
Fax
(314) 878-7453
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 30541 MO Primary

Addresses

Primary practice location

226 S Woods Mill Rd
Suite 60W
Chesterfield, MO 63017-3662

Mailing address

226 South Woods Mill Road
Suite 60W
Chesterfield, MO 63017-3665
Phone (314) 878-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30541MOMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417066044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 SOUTH WOODS MILL ROAD",
            "address_2": "SUITE 60W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173665",
            "telephone_number": "314-878-7333",
            "fax_number": "314-878-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD",
            "address_2": "SUITE 60W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173662",
            "telephone_number": "314-878-7333",
            "fax_number": "314-878-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "GORDON",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "30541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.