Active NPI
Denise S Goettsche, DO
- Family Medicine Physician
- Provo, UT
National Provider Identifier
1740225218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5368669 1204
- Practice address
- 1300 E Center St
Provo, UT 84606-3554 - Phone
- (801) 344-4400
- Fax
- (801) 344-4225
- NPI assigned
- Jun 18, 2006
- Last updated
- Jul 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5368669 1204 | UT | Primary |
Addresses
Primary practice location
1300 E Center St
Provo, UT 84606-3554
Mailing address
PO Box 270
Provo, UT 84603-0270
Phone (801) 344-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1300 E Ctr St
Utah State Hospital
Provo, UT 84606-3554
Phone (801) 344-4215
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5368669 1204 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Utah | Current | Accepting new patients |
Locations
1300 E Center St
Provo, UT 84606
Phone (801) 344-4215
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564012800000",
"number": "1740225218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"city": "PROVO",
"state": "UT",
"postal_code": "846030270",
"telephone_number": "801-344-4400",
"fax_number": "801-344-4225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 E CENTER ST",
"city": "PROVO",
"state": "UT",
"postal_code": "846063554",
"telephone_number": "801-344-4400",
"fax_number": "801-344-4225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETTSCHE",
"first_name": "DENISE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-18",
"last_updated": "2019-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "5368669 1204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.