Dana Lynn Gooch

Key facts

NPI

1497522957

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

2004004175 (MO)

Practice address

328 W 7TH St
Hermann, MO 65041-1216

Phone

(573) 486-2116

NPI assigned

Dec 5, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 5, 2023.

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1497522957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 TSCHAPPLER RD",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650662319",
            "telephone_number": "573-259-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W 7TH ST",
            "city": "HERMANN",
            "state": "MO",
            "postal_code": "650411216",
            "telephone_number": "573-486-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "DANA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2004004175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermann, MO

• Gasconade County Health Department
• Gasconade County R-I School District
• Abby M Gerlemann, FNP-C
• Gary John Giesler, O.D.
• April Gildehaus, MT
• Douglas Steven Goracke, M.D.
• Elizabeth A Gramith, CRNA
• Darcy L Hadley, C.R.N.A.
• Stanley R Hall, PA-C
• Diane V. Hartman, M.S.W., L.C.S.W.

All providers in Hermann, MO · Physical Therapy Assistant in Missouri