Active NPI
Taylor E Goldammer, MD
- Pediatrics Physician
- Columbia, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2018019892
- Practice address
- 404 N Keene St
Columbia, MO 65201-6626 - Phone
- (573) 882-4438
- Fax
- (573) 884-9992
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2018019892 | MO | Primary |
Addresses
Primary practice location
404 N Keene St
Columbia, MO 65201-6626
Mailing address
400 N Keene St
Columbia, MO 65201-6626
Phone (573) 882-4438
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018019892 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson City Medical Group, P.C. | Current | Accepting new patients | |
| Mercy Clinic East Communities | Pediatrics | Current | Accepting new patients |
| Jefferson City Medical Group, P.C. | Current | Accepting new patients | |
| Jefferson City Medical Group, P.C. | Current | Accepting new patients | |
| Jefferson City Medical Group, P.C. | Current | Accepting new patients | |
| Jefferson City Medical Group, PC | Past | Accepting new patients | |
| Mercy Hospitals East Communities | Past | Accepting new patients |
Locations
3530 Jeffco Blvd
Ste 110
Arnold, MO 63010
Phone (314) 467-3800
1241 W Stadium Blvd
Ste 1100
Jefferson Cty, MO 65109
Phone (573) 556-5747
1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771
12348 Old Tesson Rd
Ste 160
Saint Louis, MO 63128
Phone (314) 251-6898
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
40 Sunset Ridge Rd
Ste 120
New Paltz, NY 12561
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Jefferson City, MO
- NPI 1336189398
-
- Hematology & Oncology Physician
- Jefferson City, MO
- NPI 1215093257
-
- Family Medicine Physician
- Fulton, MO
- NPI 1649099714
-
- Clinical Medical Laboratory
- Jefferson City, MO
- NPI 1811292105
-
- Rural Health Clinic/Center
- California, MO
- NPI 1710400221
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1780170712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016626",
"telephone_number": "573-882-4438",
"fax_number": "573-884-9992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 N KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016626",
"telephone_number": "573-882-4438",
"fax_number": "573-884-9992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDAMMER",
"first_name": "TAYLOR",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-02",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2018019892",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.1",
"affiliationName": "Bluemark LLC",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "40 Sunset Ridge Rd Ste 120",
"city": "New Paltz",
"state": "NY",
"country_code": "US",
"postal_code": "125611039",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.