Individual provider Active NPI

Jessica Mae Goins, FNPBC

  • Family Medicine Physician
  • Wentzville, MO
National Provider Identifier
1609524917
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021038361 Issued in MO
Practice address
1502 W Meyer Rd
Wentzville, MO 63385-3653
Phone
(636) 698-6266
NPI assigned
Mar 15, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021038361 MO Primary

Addresses

Primary practice location

1502 W Meyer Rd
Wentzville, MO 63385-3653

Mailing address

31 Mac LN
Troy, MO 63379-4951
Phone (636) 251-0206

Other practice location 1

521 Anwijo Way
Warrenton, MO 63383-1388
Phone (636) 456-6103

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220504002088 MO Practitioner - Nurse Practitioner 7810384112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

1502 W Meyer Rd
Wentzville, MO 63385-3653
Phone (636) 698-6266

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine Current Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince May 16, 2022 Accepting new patients
Mercy Clinic Heart and Vascular, LLC Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

521 Anwijo Way
Warrenton, MO 63383
Phone (636) 239-7344

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

1502 W Meyer Rd
Wentzville, MO 63385
Phone (636) 698-6200

10 Wildcat Dr
Wright City, MO 63390
Phone (636) 791-9997

Interoperability endpoints

  • Direct secure messaging: jgoins1025269@directc.mercy.net

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1609524917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MAC LN",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633794951",
            "telephone_number": "636-251-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W MEYER RD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853653",
            "telephone_number": "636-698-6266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 Anwijo Way",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "MO",
            "postal_code": "633831388",
            "country_code": "US",
            "telephone_number": "636-456-6103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOINS",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "credential": "FNPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021038361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

Verify at the official NPI Registry.