Jeri Clark Goen, PA - C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

408 Issued in OK

Practice address

3807 S Peoria Ave
Suite G and H
Tulsa, OK 74105-3145

Phone

(918) 359-7845

Fax

(918) 359-7849

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Quick Clinic LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1356412225
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1740355460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 S COLLEGE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045233",
            "telephone_number": "918-902-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3807 S PEORIA AVE",
            "address_2": "SUITE G AND H",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741053145",
            "telephone_number": "918-359-7845",
            "fax_number": "918-359-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEN",
        "first_name": "JERI",
        "middle_name": "CLARK",
        "credential": "PA - C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Godwin
• Hannah Godwin, RBT
• Josalynn Godwin
• Katherine L Godwin, MD
• Sherrie Tina Goehler, PHARMD
• Kale Scott Goerke, D.O.
• Brian Goetsch, PSY.D.
• Carol Brinster Goetz
• Jeanette Louise Goetz, LPC LADC
• Kathryn Goff, P.T., D.P.T.

• Medical Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.