Gregory R Goodwin, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

102077 Issued in MO

Practice address

100 Hospital Dr
Lebanon, MO 65536-9210

Phone

(417) 533-6100

Fax

(417) 533-6173

NPI assigned

Aug 22, 2006

Last updated

Aug 5, 2015By the provider in NPPES

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

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Hospital Aurora

  • Critical Access Hospital
  • Aurora, MO
  • NPI 1467543090
  Medicare reassignment NPD
• Mercy Hospital Lebanon

  • General Acute Care Hospital
  • Lebanon, MO
  • NPI 1447284898
  Medicare reassignment NPD
• Mercy St. Francis Hospital

  • Critical Access Hospital
  • Mountain View, MO
  • NPI 1023053477
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• Mercy Hospital Aurora

  • Medicare Defined Swing Bed Hospital Unit
  • Aurora, MO
  • NPI 1295878981
  NPD
• Mercy Hospital Lebanon

  dba Mercy Surgery Center-Lebanon at Rolla

  • Ambulatory Surgical Clinic/Center
  • Rolla, MO
  • NPI 1043562358
  NPD
• Mercy St. Francis Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Mountain View, MO
  • NPI 1043357015
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1689780744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369210",
            "telephone_number": "417-533-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369210",
            "telephone_number": "417-533-6100",
            "fax_number": "417-533-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "GREGORY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "102077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431767432",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689780744",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Healthcare Center LLC
• Philip V Giblin, MSW, LCSW
• Ronald D. Glas, MD
• Amanda Carol Glendenning, PT
• Christina Goans, PHARMD
• Jeramie Sousa Gorman, PLPC
• Mary Kathryn Goslin, LPC
• Monika Goyal, MD
• Jason G Grant, CRNA
• William Grant III, O.D.

• Emergency Medicine Physician in Lebanon, MO
• Providers in Lebanon, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.