Ryan Goergen, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2014038355 Issued in MO

Practice address

4055 Lindell Blvd
Saint Louis, MO 63108-3201

Phone

(314) 535-7701

NPI assigned

Oct 29, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ryan.goergen@direct.phcenters.nextgenshare.com

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.

• Betty Jean Kerr People'S Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1194797787
  Medicare reassignment NPD
• Betty Jean Kerr People'S Health Centers

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1679604318
  NPD

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1487059721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3143 EVERGLADE AVE",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173316",
            "telephone_number": "630-291-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083201",
            "telephone_number": "314-535-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERGEN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-29",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2014038355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Punit Goel, MD
• Emily Griffard Goeller, M.D.
• Susan L Goen, LMT
• Mallory Goepel, NNP-BC
• Christine Goepfert, MD
• Daniel Austin Goering, MD
• Michelle Goetz, D.O.
• Marie Christine Goez, CRNA
• Austin Tanner Goff, DO
• Joshua S Goff, LMSW, MS.

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.

Verify at the official NPI Registry.