Kaitlyn Taylor Kristina Gotthardt

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3165 McKelvey Rd
Bridgeton, MO 63044-2550

Phone

(314) 206-3900

NPI assigned

Jun 12, 2017

Sex

Female

Sole proprietor

No

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)

Not enrolled

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1760912893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SAINT ANTHONY DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352111",
            "telephone_number": "636-373-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 MCKELVEY RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442550",
            "telephone_number": "314-206-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTHARDT",
        "first_name": "KAITLYN",
        "middle_name": "TAYLOR KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacie Gorden
• Thomas Gordon, PHARM D
• Mary Jo Gorman, M.D.
• Bryan John Goss, ACNP
• Thomas Michael Gotsis, DDS
• Taryn Lorraine Gough
• Courtney R Grady
• Catherine M Graham, MD
• Robert Graninger, PT, DPT, ATC
• Jacob Graves, CCC-SLP

• Community Health Worker in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Community Health Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.