Individual provider Active NPI

Caitlin Elisabeth Golliver, APRN-CNP

  • Nurse Practitioner
  • O Fallon, MO
National Provider Identifier
1821877465
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2023038253 Issued in MO
Practice address
1101 Highway K
O Fallon, MO 63366-8431
Phone
(636) 379-6363
Fax
(636) 379-1297
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2023038352 MO
Nurse Practitioner 363L00000X 2023038253 MO Primary

Addresses

Primary practice location

1101 Highway K
O Fallon, MO 63366-8431

Mailing address

1101 Highway K
O Fallon, MO 63366-8431
Phone (636) 379-6363

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003002721 MO Practitioner - Nurse Practitioner 5890149215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

300 Medical PLZ
Suite 310
Lake St Louis, MO 63367-1484
Phone (636) 625-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023038352MOMDObstetrics & Gynecology Physician
2023038253MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Oct 2, 2023 Accepting new patients
SSM Medical Group Inc. CurrentSince Oct 2, 2023 Accepting new patients

Locations

300 Medical Plz
Ste 310
Lake St Louis, MO 63367
Phone (314) 291-6556

1101 Highway K
O Fallon, MO 63366
Phone (636) 379-6347

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Interoperability endpoints

  • Direct secure messaging: cgolliver121440@direct-ehr-ssmhc.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1821877465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633668431",
            "telephone_number": "636-379-6363",
            "fax_number": "636-379-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633668431",
            "telephone_number": "636-379-6363",
            "fax_number": "636-379-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLIVER",
        "first_name": "CAITLIN",
        "middle_name": "ELISABETH",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2023038352",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023038253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.